Funeral Plan Application Form

1. Plan Holder's Details

Title *

if other: *

Name *

First

Last

Date Of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Email *

Religion

2. Plan Holder's Next of Kin / Executor

Title *

Name *

First

Last

Date Of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Relationship to plan holder *

Email *

Next of Kin is also Representative? *

Yes
No

3. Plan Holder's Representative

Title *

Name *

First

Last

Date Of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Email *

Relationship to plan holder

4. Guaranteed Funeral Services

Chosen Funeral Plan (Price includes fee to set up and manage the funeral plan) *

Direct Cremation – £1,449
Personalised – £3,644

Preferred Payment Method? *

Who would you like the plan details to go to? (You can tick multiple boxes) *

Plan Holder
Next of Kin / Executor
Plan Holder’s Representative

Funeral Wishes

Please tell us any other wishes you may have for example return of ashes or scattering in garden of remembrance.

Data Protection *

Please tick here to confirm you are happy for Fosters Family Funeral Directors to contact you by post, phone or email with information regarding other services we offer.

Available 24 hours 7 days a week

0800 121 8090

1. Plan Holder's Details

2. Plan Holder's Next of Kin / Executor

3. Plan Holder's Representative

4. Guaranteed Funeral Services

Funeral Wishes

Call Our 24hr Helpline

We Charge Less So You Can Do More

Further Information

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