Prepaid Funeral Plans

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1. Confirm Your Plan {{step1.titleText}} Change your plan

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Your plan summary

Do you have a reference code?

If you have a reference code please insert it here and click Apply

Please choose your plan below and select continue to go to the next step.

Key Benefits

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Please select one of the plans above

2. Your Personal Details {{step2.titleText}} Change your personal details

Your Personal Details

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Please enter your first name(s)

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Please enter your surname

Please enter a valid email address

Please enter your desired contact email address

Please enter the same email address

Please re-enter your contact email address. Be sure to double check your spelling

Please select an option

If you are purchasing this plan for someone else, please select 'No'

* Required Information

3. Address and Phone Details {{step3.titleText}} Change your address

Address and Phone Details

Buyer's Details

Please enter your details below.

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Please select your title from the list of options

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Please provide the buyer's title

Please enter your first name(s)

Please enter your surname

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Please enter your post code, click the 'Look up' button and select your address from the list

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Please enter the first line of your address

Please enter the second line of your address

Please enter the third line of your address

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Please enter the name of your town or city

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Please enter the name of your county

Please enter your desired telephone number (this can be a mobile number, if preferred)

Please enter your mobile number

Please enter your desired email address

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Please select a gender

Please enter a date in DD/MM/YYYY format. You must be over 18.

Please enter your date of birth in the format DD/MM/YYYY

Planholder's Details

Please enter the details of the person you're buying this plan for - this is purely for our records. We won't contact them directly.

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Please select your title from the list of options

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Please provide the Member's title

Please enter your first name(s)

Please enter your surname

Please enter your post code, click the 'Look up' button and select your address from the list

Please enter the first line of your address

Please enter the second line of your address

Please enter the third line of your address

This field is required

Please enter the name of your town or city

This field is required

Please enter the name of your county

Please enter your desired telephone number (this can be a mobile number, if preferred)

Please enter your mobile number

Please enter your desired email address

Please enter a date in DD/MM/YYYY format. You must be over 50

Please enter your date of birth in the format DD/MM/YYYY. The planholder must be aged 50 or over.

Please enter the planholder's date of birth in the format DD/MM/YYYY. The planholder must be aged 50 or over.

Please select a gender

* Required information

4. Payment Options {{step4.titleText}} Change your payment

Payment Options

How would you like to pay for your plan?

(Instalment amounts offered will be dependant on the oldest person named on the plan)

Over what term would you like the Direct Debit to be set?

{{form.PaymentTerms == 1 ? "You have chosen to pay by single payment." : form.PaymentTerms > 1 ? "You have chosen to pay by Direct Debit, your payment terms are:" : ""}}

{{selectedPaymentGridItem.Instalments-1}} Monthly payments at {{selectedPaymentGridItem.RegularAmt| currency:"£":2}} and a final payment of {{selectedPaymentGridItem.LastAmt| currency:"£":2}}
Total amount payable will be {{selectedPaymentGridItem.Totalprice| currency:"£":2}}

Cost for plans greater than 12 months include an instalment charge (this is included in your total)

5. Confirm Your Details {{step5.titleText}} Change your details

Please check that the details you have entered are correct

Planholder details

Name: {{form.MemberTitle}}. {{form.MemberFirstname}} {{form.MemberLastname}}
Date of Birth: {{form.MemberDoBDay}}/{{form.MemberDoBMonth}}/{{form.MemberDoBYear}}
Telephone number: {{form.MemberPhoneNumber}}
Mobile number: {{form.MemberMobilePhoneNumber}}
{{form.MemberAddress1}}
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{{form.MemberAddress3}}
{{form.MemberAddressTown}}
{{form.MemberAddressCounty}}
{{form.MemberPostcode}}

Change Address and Phone Details

Buyer details

Name: {{form.BuyerTitle}}. {{form.BuyerFirstname}} {{form.BuyerLasttname}}
Telephone number: {{form.BuyerPhoneNumber}}
Mobile number: {{form.BuyerMobilePhoneNumber}}
{{form.BuyerAddress1}}
{{form.BuyerAddress2}}
{{form.BuyerAddress3}}
{{form.BuyerAddressTown}}
{{form.BuyerAddressCounty}}
{{form.BuyerPostcode}}

Contact email: {{form.Email}}

Change Contact Details

Your chosen plan: {{selectedPlan.PlanName}}

Change Your Plan

Payment Option

You have chosen to pay by single payment.

£{{selectedPaymentGridItem.RegularAmt | number : 2}}

You have chosen to pay by Direct Debit, your payment terms are:

{{selectedPaymentGridItem.Instalments -1}} instalments at: £{{selectedPaymentGridItem.RegularAmt | number : 2}}

1 instalment at: £{{selectedPaymentGridItem.LastAmt | number : 2}}

Change Payment Options

Please choose the type of funeral service you would like

Please select an option

How did you hear about us?

You must agree to this checkbox

6. Payment Details {{step6.titleText}}

You have chosen to pay by a single payment of {{chosenPaymentText | currency:"£"}}

Please confirm the address of the cardholder to complete the transaction

If the cardholder's address is shown below, please make sure it is selected. If not, click 'Use A Different Billing Address'

You have chosen to pay monthly by Direct Debit

Please enter your bank details for Direct Debit payment

All the normal Direct Debit safeguards and guarantees apply. No change in the amount, date or frequency can be made without notifying you at least 10 working days in advance of your account being debited

In the event of any error, you are entitled to an immediate refund from your bank or building Society

Instruction to your Bank or Building Society to pay by Direct Debit

To setup your Direct Debit, please enter your bank account details below:

The details of your Direct Debit Instruction will be sent to you within 3 working days or no later than 10 working days before the first collection

Please enter a valid sort code
Please enter a valid account number
You must verify that you are the account owner
You must agree to this checkbox to continue
You must agree to this checkbox to continue

Please confirm the bank details you have entered are correct before proceeding further

The company name which will appear on your bank statement against the Direct Debit will be National Funeral Trust.

Confirmation of the Direct Debit will be sent to you by post, no later than 10 working days before the first collection.

In order to purchase a Dignity Funeral Plan by Direct Debit you must be the account holder of a personal bank or building society account in the United Kingdom. If you are not the only required signatory on your account, have a company account, or would rather send us a paper version of this form please call us on 0800 033 4717.

Banks and Building Societies may not accept Direct Debit Instructions for some types of account.

Service user's name, address and ID (below) are for office use only:
Service user's name and address: Royal Exchange Trust Company Limited Re National Funeral Trust,
4 King Edwards Court, King Edwards Square, Sutton Coldfield, West Midlands B73 6AP
Service user number: 920149
Reference number: {{referenceNumber}}

Please confirm the address of the bill payer

Bill Payer's Details

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Please select your title from the list of options

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Please provide the Billing's title

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Please enter your first name(s)

This field is required

Please enter your surname

Please enter your postcode and select the address from the list

Please enter the first line of your address

Please enter the second line of your address

Please enter the third line of your address

This field is required

Please enter the name of your town or city

This field is required

Please enter the name of your county

This field is required

Please enter your desired contact number

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Please enter the bill payer's desired contact email address

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Please re-enter the bill payer's contact email address. Be sure to double check your spelling

When you press continue, you will be transferred to our payment partner, WorldPay.