funeralbooking.co.uk
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54.217.131.1
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URL:
https://funeralbooking.co.uk/
Submission: On August 05 via api from US — Scanned from DE
Submission: On August 05 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMName: funeral_form —
<form class="section-md parent-border-bottom" id="funeral_form" name="funeral_form">
<div class="row" id="email-row">
<div class="mb-1 col-lg-8 col-sm-10 form-centered-col question">
<label for="email_input" class="form-label">Email address</label>
<input type="email" class="form-control" id="email_input" name="email_input" placeholder="name@example.com">
</div>
</div>
<input type="hidden" name="selectedOption" id="selectedOption">
<div class="row" id="deceased-details">
<div class="mb-1 col-lg-8 col-sm-10 form-centered-col question">
<div class="row">
<div style="font-size: 26px;"> Details of the deceased: </div>
</div>
<div class="row">
<div class="col-lg-4">
<label for="name_input" class="form-label">Name</label>
<input type="text" class="form-control" id="name_input" name="name_input" placeholder="">
</div>
<div class="col-lg-4">
<label for="middle_name_input" class="form-label">Middle Name (optional)</label>
<input type="text" class="form-control" id="middle_name_input" name="middle_name_input" placeholder="">
</div>
<div class="col-lg-4" style="margin-bottom: 10px;">
<label for="last_name_input" class="form-label">Last Name</label>
<input type="text" class="form-control" id="last_name_input" name="last_name_input" placeholder="">
</div>
<div class="col-lg-6">
<label for="dob_input" class="form-label">Date of Birth</label>
<input type="date" class="form-control" id="dob_input" name="dob_input">
</div>
<div class="col-lg-6">
<label for="dod_input" class="form-label">Date of Death</label>
<input type="date" class="form-control" id="dod_input" name="dod_input">
</div>
</div>
</div>
</div>
<div id="editable-section">
<!-- coffin -->
<div class="row">
<div class="question col-lg-8 col-sm-10 form-centered-col">
<div class="size-20">Select a coffin from the funeral home:</div>
<div id="coffin-selection-container" class="items-cards">
</div>
</div>
</div>
<!-- flowers -->
<div class="row">
<div class="question col-lg-8 col-sm-10 form-centered-col">
<div class="size-20">Select a flower from the funeral home:</div>
<div id="flower-selection-container" class="items-cards">
</div>
</div>
</div>
<!-- church -->
<div class="row">
<div class="question col-lg-8 col-sm-10 form-centered-col">
<div class="size-20">Select the church:</div>
<div id="church-selection-container">
</div>
</div>
</div>
<!-- cemtery -->
<div class="row">
<div class="question col-lg-8 col-sm-10 form-centered-col">
<div class="size-20">Select the cemetery:</div>
<div id="cemetery-selection-container">
</div>
</div>
</div>
<div class="row">
<div class="question col-lg-8 col-sm-10 form-centered-col">
<div class="size-20">Choose your preffered dates:</div>
<div id="calendar"></div>
</div>
</div>
</div>
<!-- Burial or cremation -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col">
<div class="question">
<label for="funeral_type" class="form-label">Would you like a Burial or Cremation?</label>
<div class="ps-3" id="funeral_type">
<input type="radio" id="burial" name="disposal" value="burial">
<label for="burial">Burial</label><br>
<input type="radio" id="cremation" name="disposal" value="cremation">
<label for="cremation">Cremation</label><br>
</div>
</div>
</div>
</div>
<!-- Religion -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label for="funeral_types">What type of funeral do you prefer?</label><br>
<div class="ps-3" id="funeral_types">
<input type="radio" id="catholic" name="religion" value="catholic">
<label for="catholic">Catholic</label><br>
<input type="radio" id="humanist" name="religion" value="humanist">
<label for="humanist">Humanist</label><br>
</div>
</div>
</div>
</div>
<!-- Service location -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Where would you like to hold the service?</label><br>
<div class="ps-3">
<input type="radio" id="church" name="agreement" value="church">
<label for="church">At a Church</label><br>
<input type="radio" id="crematorium" name="agreement" value="crematorium">
<label for="crematorium">At a Crematorium</label><br>
<input type="radio" id="funeral_home" name="agreement" value="funeral_home">
<label for="funeral_home">At the Funeral Home</label><br>
<input type="radio" id="home" name="agreement" value="home">
<label for="home">At Home</label><br>
</div>
</div>
</div>
</div>
<!-- Wake Location -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Where will you hold the Wake?</label>
<div class="ps-3">
<input type="radio" id="wake_home" name="wake" value="home">
<label for="wake_home">At Home</label><br>
<input type="radio" id="wake_funeral_home" name="wake" value="funeral_home">
<label for="wake_funeral_home">At the Funeral Home</label>
</div>
</div>
</div>
</div>
<!-- Remains location -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col">
<div class="question">
<label for="remains" class="form-label">Where are the remains?</label>
<textarea class="form-control" id="remains" rows="2"></textarea>
<div class="form-text">Please be specific</div>
</div>
</div>
</div>
<!-- Removal Section -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Removal on the day before or on the day of the funeral</label>
<div class="ps-3">
<input type="radio" id="removal_day_before" name="removal_day" value="day_before">
<label for="removal_day_before">Day before</label><br>
<input type="radio" id="removal_day_of" name="removal_day" value="day_of">
<label for="removal_day_of">Day of</label>
</div>
</div>
</div>
</div>
<!-- Embalming Section -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Do you want us to collect, embalm, and dress the remains?</label>
<div class="ps-3">
<input type="radio" id="embalm_yes" name="embalm" value="yes">
<label for="embalm_yes">Yes</label><br>
<input type="radio" id="embalm_no" name="embalm" value="no">
<label for="embalm_no">No</label>
</div>
<div class="form-text">Please prepare the clothes that you want the deceased to wear during the funeral </div>
</div>
</div>
</div>
<!-- Family Carry Coffin -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Will the family carry the coffin at the funeral?</label>
<div class="ps-3">
<input type="radio" id="carry_yes" name="carry" value="yes">
<label for="carry_yes">Yes</label><br>
<input type="radio" id="carry_no" name="carry" value="no">
<label for="carry_no">No</label>
</div>
</div>
</div>
</div>
<!-- Grave Marker -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Do you want us to get the grave marker?</label>
<div class="ps-3">
<input type="radio" id="grave_marker_yes" name="grave_marker" value="yes">
<label for="grave_marker_yes">Yes</label><br>
<input type="radio" id="grave_marker_no" name="grave_marker" value="no">
<label for="grave_marker_no">No</label>
</div>
<div class="form-text">The exact dimensions and message to be discussed later</div>
</div>
</div>
</div>
<!-- Limousine -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Limousine / no limousine</label>
<div class="ps-3">
<input type="radio" id="limousine_yes" name="limousine" value="yes">
<label for="limousine_yes">Yes</label><br>
<input type="radio" id="limousine_no" name="limousine" value="no">
<label for="limousine_no">No</label>
</div>
</div>
</div>
</div>
<!-- Notices -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Newspaper / radio / RIP.ie</label>
<div class="ps-3">
<input type="radio" id="notice_write" name="notice" value="write_now">
<label for="notice_write">Write down the notice right now</label><br>
<input type="radio" id="notice_mail" name="notice" value="mail_later">
<label for="notice_mail">Mail it to us later</label>
</div>
</div>
</div>
</div>
<!-- Music -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Do you want music at the service?</label>
<div class="ps-3">
<input type="radio" id="music_yes" name="music" value="yes">
<label for="music_yes">Yes</label><br>
<input type="radio" id="music_no" name="music" value="no">
<label for="music_no">No</label>
</div>
<textarea class="form-control mt-2" id="music_text" rows="2" placeholder="Please specify what music"></textarea>
</div>
</div>
</div>
<!-- Service Booklets -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label for="service_booklets">Mass/service booklets?</label>
<div class="ps-3">
<input type="radio" id="booklets_yes" name="booklets" value="yes">
<label for="booklets_yes">Yes</label><br>
<input type="radio" id="booklets_no" name="booklets" value="no">
<label for="booklets_no">No</label>
</div>
<div class="form-text">Booklets are provided by the funeral home of your choice, for additional customization please contact them.</div>
</div>
</div>
</div>
<!-- Photograph -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Photograph / no photograph</label>
<div class="ps-3">
<input type="radio" id="photo_yes" name="photo" value="yes">
<label for="photo_yes">Yes</label><br>
<input type="radio" id="photo_no" name="photo" value="no">
<label for="photo_no">No</label>
</div>
<input type="file" class="form-control mt-2 hidden" id="photo_upload" accept="image/*">
</div>
</div>
</div>
<!-- Singer -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col radio">
<div class="question">
<label>Singer for funeral mass - 300</label>
<div class="ps-3">
<input type="radio" id="singer_yes" name="singer" value="yes">
<label for="singer_yes">Yes</label><br>
<input type="radio" id="singer_no" name="singer" value="no">
<label for="singer_no">No</label>
</div>
</div>
</div>
</div>
<!-- Lunch -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col">
<div class="question">
<label for="lunch">Lunch for family and friends after the funeral</label>
<textarea class="form-control" id="lunch" rows="3" placeholder="Provide description"></textarea>
</div>
</div>
</div>
<!-- Additional Wishes or Comments -->
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col">
<div class="question">
<label for="additional_wishes">Additional wishes or comments?</label>
<textarea class="form-control" id="additional_wishes" rows="3"></textarea>
</div>
</div>
</div>
<div id="order-summary">
<div class="question centered">
<div class="row d-flex text-center">
<h1>Order Summary:</h1>
</div>
<div id="order-items" class="col-lg-8 col-sm-10 centered">
<div class="row">
<div class="bot-border d-flex justify-content-between align-items-center form-centered-col">
<span>Funeral Directors’ administration charge</span>
<span data-price="" class="price-summary" id="administrator-charge"></span>
</div>
</div>
</div>
<div class="row">
<div class="col-lg-8 col-sm-10 form-centered-col d-flex justify-content-between">
<span style="font-size:30px;"> Total: </span>
<div id="total" style="font-size:40px; font-weight: bold;">
</div>
</div>
</div>
</div>
</div>
<!-- submit -->
<div class="container h-100" id="submit-button-container">
<div class="row h-100 justify-content-center align-items-center">
<div class="col-auto question">
<button type="submit" class="btn btn-outline">Review order</button>
</div>
</div>
</div>
</form>
Text Content
* About Funerals * Packages +353 874 928 391 FUNERAL BOOKING Let us guide you through the process of planning a funeral. Select one of our prepared packages and customize whatever you would like to have at the funeral. Everything will be handled for you, simply choose your prefered funeral home and let us do the rest. Find Funeral Home ABOUT US We are a platfrom that connect reputable funeral directors with grieving families to allow a seemless and painless process Learn More OUR PROCESS After selecting one of our four preselected packages you can adjust the aspect of the funeral that you would like to customize. Once you have customized what you want at the funeral, we will connect you with our funeral provider of your choice. Learn More View funeral homes nearby: Previous Next OUR PACKAGES BASIC €∼4000 A cost-effective cremation option with essential services, including a basic coffin and crematorium service. View Now STANDARD €∼6000 A comprehensive burial package featuring a Catholic service, standard coffin, cemetery plot, and additional amenities like limousine service and music. View Now PREMIUM €∼8500 A premium burial package offering a full Catholic service with a high-quality coffin, limousine service, comprehensive announcements, and a wake at the funeral home. View Now ECO PACKAGE €∼6000 An environmentally conscious cremation package with an eco-friendly coffin and crematorium service. View Now Email address Details of the deceased: Name Middle Name (optional) Last Name Date of Birth Date of Death Select a coffin from the funeral home: Select a flower from the funeral home: Select the church: Select the cemetery: Choose your preffered dates: Would you like a Burial or Cremation? Burial Cremation What type of funeral do you prefer? Catholic Humanist Where would you like to hold the service? At a Church At a Crematorium At the Funeral Home At Home Where will you hold the Wake? At Home At the Funeral Home Where are the remains? Please be specific Removal on the day before or on the day of the funeral Day before Day of Do you want us to collect, embalm, and dress the remains? Yes No Please prepare the clothes that you want the deceased to wear during the funeral Will the family carry the coffin at the funeral? Yes No Do you want us to get the grave marker? Yes No The exact dimensions and message to be discussed later Limousine / no limousine Yes No Newspaper / radio / RIP.ie Write down the notice right now Mail it to us later Do you want music at the service? Yes No Mass/service booklets? Yes No Booklets are provided by the funeral home of your choice, for additional customization please contact them. Photograph / no photograph Yes No Singer for funeral mass - 300 Yes No Lunch for family and friends after the funeral Additional wishes or comments? ORDER SUMMARY: Funeral Directors’ administration charge Total: Review order We are an online funeral booking service, making the mourning period easier for grieving families Email: filip.black.cerny@gmail.com Offices: The Chq Building, Custom House Quay, North Wall, Dublin