• Planning Ahead

    Pre-Arrangement Form – 40%-60% OFF FUNERAL HOME PRICES
    One of the advantages of prearranging your own funeral is that it plans for your final wishes prior to the time of need. This removes a huge burden from your family when you take care of the necessary funeral details and you provide all the information that we need. The following form allows you to send us the information we need to complete your prearrangements.

    Please Enter Your Info Below

    Arrangement Type (required)

    Your Name (required)

    Relationship (required)

    Your Address (required)

    City, State, Zip (required)

    Your Phone Number(required)

    Your Email (required)

    Decedent’s Information

    Decedent’s Name (First,Middle,Last) (required)

    Decedent’s Street Address(required)

    City,State,Zip (required)

    County (required)

    Inside City Limits (required)

    Decedent’s Date of Birth (Month, Day, Year): (required)

    Birthplace (City,
    State or Foreign Country) (required)

    Social Security # (required)

    Sex (required)

    Race (required)

    Was Decedent of Hispanic or Haitian Origin? (required)

    If Yes Specify

    Decedent’s Education

    Decedent’s Usual Occupation (most of life)
    Please do not use Retired

    Kind of Business /Industry

    Decedent’s Father’s Name (First, Middle, Last)

    Decedent’s Mother’s Name (First, Middle,Maiden Name)

    Decedent’s Marital Status

    Decedent’s Surviving Spouse (if wife, give maiden name)

    Was Decedent Ever In Armed Forces?

    If yes, Which Branch of Service?

    Decedent’s Living Next of Kin

    Service Information

    Method of Disposition of Body (required)

    Items to be removed from body and returned to family

    Items to Remain in Casket for Disposition:

    Casket Instructions

    Cemetery Name







    If yes, Where

    Urn Choice

    Casket Choice

    Vault Choice

    Flower Choice

    Clergy Requested

    Music Requested

    Clothing Requested

    Special Requests to Funeral Home

    Newspaper Information

    Type Your Own Obituary

    Surviving Relatives (List Relationship,First & Last Names)

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