Because We Care...

Today, more and more people are choosing to plan their funerals in advance. We find that there are three basic reasons why our families think this makes sense:

It relieves an emotional burden from those you love.
By being able to make sound decisions in advance, without stress, you can free your loved ones from this responsibility. This allows them to concentrate on supporting each other, rather than being asked to make several major decisions at a very emotional time.

You can express your own wishes.
Often families are confused about what is proper. They may agonize over what you would have wanted. be selecting your options in advance, there is no doubt. And, you can even change your mind later, if you wish.

You can relieve the financial burden from those you love.
If you also choose to handle the funding of your funeral in advance, we have plans that will assure that your survivors will never have to pay any additional funds for the services and merchandise you selected.

You may be amazed at how good it makes you feel to get your wishes on file with us. Enjoy the peace of mind that these decisions have not been left for others to face.

By talking with one of our Funeral Planning Professionals, you will receive all of the information you need to decide what is right for you.

Personal Information

Name (first, MI, last)
Marital status	Single Married Divorced Widowed
Social Security#
Date of Birth
Place of Birth
Address
City
County
State
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:
Work/Education History
Education (0-12):     College 1-5+:
Occupation:
Business:
Company:
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:
Person in Charge:
Address:
Phone:
Insurance Information:
Funeral Service Request
Place of Service	Funeral Home Church
Funeral Home
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place of Worship:
Lodge/Union:
Person in Charge of Final Arrangements
Disposition Request
Cemetery:
Address:
Phone:
Section:
I have made a last will and testament: Yes   No
Location:
Other Instructions:
Memorials/Donations to Charity:
Please select one of these options:  Send information about pre-arrangements Contact me to set up an appointment Please keep my information on file