What is Pre-Need, and what can it do for me and my family?

Pre-Need is not a new concept. It is one that more and more families are taking advantage of each year. Simply put, pre-arrangement is planning ahead for funeral services for yourself or a loved one.

Although a sensitive subject, prearranging gives you the opportunity to share your thoughts and make your decisions with those closest to you. It gives your loved ones guidelines to follow at the time of a funeral, and it assures you that your personal wishes will be carried out. We accept transferred Pre-arrangements.

By assuming responsibility for your plans, you are able to relieve those you love of the burden of decision making at one of the most difficult times in their lives.
Personal Information
Name
(First MI Last):
Marital Status:   Social_Security #:
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: E-mail:
Spouse's Name: Spouse's Maiden Name:
Place of
Marriage: 		Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:


Work/Education History
Education (0-12):
 College 1-5+:
Occupation:
Business:
 Company:
Schools Attended and Graduation Years

Military Record
Branch of Service: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Copy of Discharge Papers:     Yes     No
Name Of Wars:

Funeral Service Request
Place Of Service:
   
Length of Visitation:
Religious Denomination:
Place Of Worship:

Newspaper Information (Please list family members)
Spouse:
Parents:
Children:
Brothers/Sisters:
Number of Grandchildren:
List any other significant relatives :

Special Instructions
Lodges, Organizations, and Offices held:
Jewelry:
Glasses:
Lodge / Union:
Person in Charge of Final Arrangements:
Clothing Preference: My own Other
Funeral Luncheon Site:


Disposition Request
I Prefer:
Cemetery:
Address: Phone:
Section:
I have made a last will and testament:     Yes     No
Location:

If Cremation, final disposition of cremated remains should be?
Burial Location:
Scattering Location:
Received By:


Other Instructions

Memorials/Donations To Charity

Please select all that apply:
Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file


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