Memories Chapel

330-18th Street North

Brandon, MB R7A 7P3

Phone: 204-727-0330

Fax: 204-725-0971

Email: office@memorieschapel.com

Immediate Need

If you have immediate need of our services, we're available for you 24 hours a day.

Obituaries & Tributes

It is not always possible to pay respects in person, so we hope that this small token will help.

Pre-Arrangement

A gift to your family, sparing them hard decisions at an emotional time.

Order Flowers

Offer a gift of comfort and beauty to a family suffering from loss.

Immediate Need - Memories Chapel & Pre-Planning Centre

I. Biographical Information
Full Name:
Date of Death:
Address1:
Address2:
City Name:
Province/Territory:
Postal Code:
Telephone Number:	(xxx-xxx-xxxx)
Email Address:
Date of Birth:	(month/day/year)
City of Birth:
Province/Territory of Birth:
Social Insurance Number:
Father's Name:
Father's Place of Birth:
Mother's Name:
Mother's Place of Birth:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence	Enter Text Here...
Relatives Who Have Preceded In Death	Enter Text Here...
Occupation:
Business Type:
Company Name:
II. Military Record
Veteran:
Branch of Service:
Regimental Number:
Date Enlisted:	(month/day/year)
Date of Discharge:	(month/day/year)
Rank at Discharge:
Time of Military Service:
III. Service Preferences
Type of Service:
Person in Charge of Arrangements:
Officiating Clergy:	List Clergy Here...
Pallbearers:	List up to eight pallbearers
Flower Preference:	Enter Flower Preference...
Music Selection:	Enter Music Selection...
Jewelry:
Glasses:
Disposition:
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:
Miscellaneous Notes and Instructions: Enter Text Here...
This form does not have to be completed in its entirety. Your funeral director will assist you and answer any questions you may have. please call 204-727-0330 for immediate assistance.

365 Days of Healing

Grieving doesn't always end with the funeral: subscribe to our free daily grief support email program, designed to help you a little bit every day, by filling out the form below.

52 Weeks of Support

It's hard to know what to say when someone experiences loss. Our free weekly newsletter provides insights, quotes and messages on how to help during the first year.