{"id":932,"date":"2014-02-18T09:49:08","date_gmt":"2014-02-18T09:49:08","guid":{"rendered":"https:\/\/www.leadbetter-murphy.com\/?page_id=932"},"modified":"2014-02-20T11:27:37","modified_gmt":"2014-02-20T11:27:37","slug":"funeral-enquiry-form","status":"publish","type":"page","link":"https:\/\/www.leadbetter-murphy.com\/contact-us\/funeral-enquiry-form\/","title":{"rendered":"Funeral Enquiry Form"},"content":{"rendered":"<p>Have you just suffered a bereavement? If\u00a0don\u2019t feel up to speaking to someone yet \u2013 don\u2019t worry. You can fill out the form below to contact our specialist team. You just need to supply some information about yourself, and some information about the person that has passed and our team will advise what the cost of the funeral would be and get in touch with you to discuss the necessary arrangements. We understand this is a difficult time and we\u2019re here to help.<\/p>\n<div role=\"form\" class=\"wpcf7\" id=\"wpcf7-f930-o1\" lang=\"en-US\" dir=\"ltr\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/wp-json\/wp\/v2\/pages\/932#wpcf7-f930-o1\" method=\"post\" class=\"wpcf7-form init\" data-status=\"init\">\n<div style=\"display: none;\">\n<input type=\"hidden\" name=\"_wpcf7\" value=\"930\" \/>\n<input type=\"hidden\" name=\"_wpcf7_version\" value=\"5.5.6.1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/>\n<input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f930-o1\" \/>\n<input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/>\n<input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<input type=\"hidden\" name=\"_wpcf7_recaptcha_response\" value=\"\" \/>\n<\/div>\n<div class=\"funeral-plan\">\n<fieldset>\n<legend>\n<h2>Your details<\/h2>\n<\/legend>\n<p>Your name<br \/>\n    <span class=\"wpcf7-form-control-wrap Name\"><input type=\"text\" name=\"Name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p>Your address<br \/>\n    <span class=\"wpcf7-form-control-wrap Address\"><textarea name=\"Address\" cols=\"40\" rows=\"4\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<p>Your phone number<br \/>\n    <span class=\"wpcf7-form-control-wrap Phone\"><input type=\"text\" name=\"Phone\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-tel wpcf7-validates-as-required wpcf7-validates-as-tel\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<p>Your email address<br \/>\n    <span class=\"wpcf7-form-control-wrap Email\"><input type=\"text\" name=\"Email\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-email wpcf7-validates-as-required wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span> <\/p>\n<\/fieldset>\n<fieldset>\n<legend>\n<h2>Details of the deceased<\/h2>\n<\/legend>\n<p>Name<br \/>\n    <span class=\"wpcf7-form-control-wrap Deceased-Name\"><input type=\"text\" name=\"Deceased-Name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Address<br \/>\n    <span class=\"wpcf7-form-control-wrap Deceased-Address\"><textarea name=\"Deceased-Address\" cols=\"40\" rows=\"4\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<p>Age<br \/>\n    <span class=\"wpcf7-form-control-wrap Deceased-Age\"><input type=\"text\" name=\"Deceased-Age\" value=\"\" class=\"wpcf7-form-control wpcf7-number wpcf7-validates-as-required wpcf7-validates-as-number\" min=\"1\" max=\"100\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Date & time of death<br \/>\n    <span class=\"wpcf7-form-control-wrap Death-Date\"><input type=\"text\" name=\"Death-Date\" value=\"\" class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-date\" aria-invalid=\"false\" \/><\/span> at <span class=\"wpcf7-form-control-wrap Death-Time\"><input type=\"text\" name=\"Death-Time\" value=\"\" size=\"8\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Religion<br \/>\n    <span class=\"wpcf7-form-control-wrap Religion\"><input type=\"text\" name=\"Religion\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Where is the deceased currently lying?<br \/>\n    <span class=\"wpcf7-form-control-wrap Lying-Place\"><input type=\"text\" name=\"Lying-Place\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Name of doctor\/GP<br \/>\n    <span class=\"wpcf7-form-control-wrap Doctor\"><input type=\"text\" name=\"Doctor\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<\/fieldset>\n<fieldset>\n<legend>\n<h2>Next of kin details<\/h2>\n<\/legend>\n<p>Name<br \/>\n    <span class=\"wpcf7-form-control-wrap Kin-Name\"><input type=\"text\" name=\"Kin-Name\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>Relationship<br \/>\n    <span class=\"wpcf7-form-control-wrap Kin-Relationship\"><input type=\"text\" name=\"Kin-Relationship\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" \/><\/span><\/p>\n<\/fieldset>\n<fieldset>\n<legend>\n<h2>Funeral details<\/h2>\n<\/legend>\n<p>Would you like to arrange a<\/p>\n<p class=\"no-cufon\"><span class=\"wpcf7-form-control-wrap Arrangements\"><span class=\"wpcf7-form-control wpcf7-radio\"><span class=\"wpcf7-list-item first\"><label><input type=\"radio\" name=\"Arrangements\" value=\"Cremation\" \/><span class=\"wpcf7-list-item-label\">Cremation<\/span><\/label><\/span><span class=\"wpcf7-list-item last\"><label><input type=\"radio\" name=\"Arrangements\" value=\"Burial\" \/><span class=\"wpcf7-list-item-label\">Burial<\/span><\/label><\/span><\/span><\/span><\/p>\n<p>Is there a church\/chapel you would like to use?<br \/>\n    <span class=\"wpcf7-form-control-wrap Church\"><input type=\"text\" name=\"Church\" value=\"\" size=\"40\" class=\"wpcf7-form-control wpcf7-text\" aria-invalid=\"false\" \/><\/span><\/p>\n<p>If there is any additional information you would like us to know, feel free to write it in the space below.<br \/>\n    <span class=\"wpcf7-form-control-wrap Extra-info\"><textarea name=\"Extra-info\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<p>What would you like us to do next?<br \/>\n    <span class=\"wpcf7-form-control-wrap Next-steps\"><textarea name=\"Next-steps\" cols=\"40\" rows=\"10\" class=\"wpcf7-form-control wpcf7-textarea\" aria-invalid=\"false\"><\/textarea><\/span> <\/p>\n<\/fieldset>\n<p><span class=\"wpcf7-form-control-wrap acceptance-682\"><span class=\"wpcf7-form-control wpcf7-acceptance\"><span class=\"wpcf7-list-item\"><label><input type=\"checkbox\" name=\"acceptance-682\" value=\"1\" aria-invalid=\"false\" \/><span class=\"wpcf7-list-item-label\">I have read and accept Leadbetter & Murphy Funerals <a href=\"\/privacy-policy\/\">Privacy Policy<\/a>.<\/span><\/label><\/span><\/span><\/span><\/p>\n<p><input type=\"submit\" value=\"Send enquiry\" class=\"wpcf7-form-control has-spinner wpcf7-submit\" \/><\/p>\n<\/div>\n<input type='hidden' class='wpcf7-pum' value='{\"closepopup\":false,\"closedelay\":0,\"openpopup\":false,\"openpopup_id\":0}' \/><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Have you just suffered a bereavement? If\u00a0don\u2019t feel up to speaking to someone yet \u2013 don\u2019t worry. You can fill out the form below to contact our specialist team. You just need to supply some information about yourself, and some information about the person that has passed and our team will advise what the cost [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":54,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"page-third-level.php","meta":[],"_links":{"self":[{"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/pages\/932"}],"collection":[{"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/comments?post=932"}],"version-history":[{"count":0,"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/pages\/932\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/pages\/54"}],"wp:attachment":[{"href":"https:\/\/www.leadbetter-murphy.com\/wp-json\/wp\/v2\/media?parent=932"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}