Arrange Now | Donald K. Walker Funeral Directors

Full Name of Person (all fields required) *

First

Middle

Last

Street Address

City

Province - Nova Scotia

Postal Code

Sex

Male
Female

Deceased has pacemaker?

Yes
No

Date of Birth

Month Day Year

Place of Birth

Town or City, Province or Country

Marital Status

Never Married
Married
Divorced (if divorced see below)
Widowed

Name of spouse (Maiden name required if name was changed)

First

Middle

Last

Name of divorced spouse (Maiden name required if name was changed)

First

Middle

Last

Address same as deceased

Yes
No

Address of spouse if different from deceased (not required if divorced)

Usual Occupation

(Prior to Retirement)

Type of Industry

Father's Name

First

Middle

Last

Place of Birth

Town/City/Province/State/Country

Mother's Maiden Name

First

Middle

Last

Place of Birth

Town/City/Province/State/Country

Name of Next of Kin *

First

Middle

Last

Street Address if different from deceased

City

Province and Postal Code

Best Number to Reach You *

Please indicate if home, cell or work #

Email Next of Kin

Relationship to Deceased *

Is this for an immediate need in your family? *

Yes
No, This is a Pre-Arrangement only
No, This is a Pre-Arrangement and I would like to be contacted to Pre-Pay the Arrangements

If you answered yes above, where is the body currently located? *

Name of Hospital, Nursing Home etc... or type N/A

Urn Requirement *

I require a painted wooden urn at a cost of $275.00
I require a clear finish wooded urn at a cost of $375.00
I will choose an urn at www.simplyurns.ca (starting at $180.00)
I require a temporary cardboard urn at no cost

I am the Next of Kin/Authorizing Agent. I certify and represent that I have the right to make such authorization and am not aware of any living person who has a superior right or any next-of-kin or legal authority that have an objection to this cremation. *

Yes

I am the Next of Kin/Authorizing Agent. I agree to hold Donald K. Walker Funeral Directors Ltd. harmless from any liability on account of said cremation. I understand that if I fail to request removal of valuable material including jewelry and dental gold that it will likely be destroyed and/or not recoverable as a result of the cremation process. *

Yes

Deliver the cremated remains to Next of Kin at address indicated above by Canada Post ($75.00 minimum fee applied). *

Yes
No

I will pick up the cremated remains at Donald K. Walker Funeral Directors Ltd. when I am notified that they are ready. *

Yes
No

I will call you to discuss collecting cremated remains.

Yes
No

Authorization Name *

First

Middle

Last

Yes. I give Donald K. Walker Funeral Directors Ltd. authorization for cremation and I understand that this is my digital signature.

Email *