"The option that relieves the burden from your family"

Pre-planned funerals, whether funded or non-funded, are when you plan your own funeral in advance. Pre-planning allows families to make difficult decisions in a more comprehensive way. Given the current trend, more than half of our funerals will derive from preplanning. This gives the families the ability to make critical decisions while everyone is still with us.

If you are ready to begin the Preplanning process, call us at:
1.800.557.4318 or fill out the form below.

Personal Information
Name (First MI Last):
Marital Status:		Single Married Separated Divorced Widow Widower
Birth Date:		Birth Place:
Current Address:
City:		State:
Zip:		County:
Phone:
E-mail:
Spouse's Name:
Spouse's Maiden Name:
Marriage Date:		Marriage Place:
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:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:		Date Discharged:
Rank At Discharge:
Discharge On File At:
Copy of Discharge Papers:		Yes No
Name Of Wars:
Funeral Service Request
Place Of Service:		Funeral Home Church Cemetery
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Newspaper Information (Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
Other significant relatives:
Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Clothing Preference:		My own Other
Disposition Request
I Prefer:		Earth Burial Mausoleum Cremation
Cemetery:
Address:
Phone:
Section:
Last will and testament exists:		Yes No
Location:
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