JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Wilsbeschikking
Mijn uitvaartwensen, zo wil ik het graag...
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Naam
Your answer
Voornamen
Your answer
Geboortedatum
MM
/
DD
/
YYYY
Telefoon
Your answer
Straat + huisnummer
Your answer
Plaats + postcode
Your answer
Email
Uw wilsbeschikking wordt u per email toegestuurd, controleer dus zeker de correctheid hiervan.
Your answer
Next
Page 1 of 13
Clear form
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Report Abuse
Terms of Service
Privacy Policy
Help and feedback
Contact form owner
Help Forms improve
Report