Haine Funeral Home & Chapel
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                Online Prearrangement

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                Prearrangement For


                Title
                 

                Surname

                Given Names
                 
                Maiden Name
                 

                Sex
                Male   Female

                Date of Birth
                 
                Place of Birth
                 

                Address
                 
                City
                 
                Province
                 
                Postal Code

                Phone
                 
                Email
                 

                Marital Status



                Kind of Business
                 
                Type of Work
                 


                Spouse


                Title
                 
                Surname
                 
                Given Names
                 
                Maiden Name
                 


                Executor


                Title

                Surname
                 
                Given Names
                 
                Address
                 
                City
                 
                Province
                 
                Postal Code
                 
                Phone Number
                 
                Email
                 


                Church Affiliation
                 


                Cremation     Burial     Entombment


                Is Cemetery Prearranged ?
                Yes     No    Not Applicable
                Cemetery Name ?
                 


                Information for Obituary



                Additional Comments




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                Contact Us


                905-227-1732

                info@hainefuneralhome.com

                26 Ormond Street South

                Thorold, ON L2V1Y4

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                Funeral Director

                on call 24 hours

                 

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