Please take a moment to fill this out.  It will be kept confidential at the funeral home and be on file when it is needed.

Full Name:
Email Address:
Address:
Social Insurance Number:
Provincial Health Card Number:
Marital Status
Spouse (With maiden name
for a woman)
Date of Birth:
Place of Birth:
Name of Father:
Father's Birthplace:
Name of Mother (With maiden name):
Mother's Birthplace:
Occupation:
Church Attended:
Cemetery:
Person to be contacted in the event of my death to finalize the arrangements.
Name:
Phone Number:
or
Name:
Phone Number:
This is the information needed.  If this is all you would like to do for now please go to the end of the page and slick submit.  Below is a list of other items that can be selected on-line.
I would prefer that memorial donations be made to
Place of Funeral i.e.: Cobb's Funeral Home Chapel or Church
My Preferences for Hymns or special music:
My Preferences for Pallbearers:
My Preferences for Honorary Pallbearers:
My Preferences for flower bearers:
Other instructions
that I have:
I wish to be contacted about making
an appointment:
Contact me at Phone Number:
Please note that this is a good start to finalizing your arrangements.  But it is important that you make an appointment to finalize what services you wish as well make sure you tell your next of kin that your arrangements are on file with us in case something unexpected happens.  All information will be kept confidential at our funeral home.

330 Whitepine Road
Riverview, NB
E1B 0E4

Phone: (506) 869-2007
Fax: (506) 869-2004

Send us an email at [email protected]