Pre-Planning
Preplanning your funeral can ease a largely difficult time for your loved-ones. It will relieve them of making difficult decisions during their time of grief. We can assist you in making informed choices when you prearrange your or your loved one's funeral.

Planning your own funeral...
  • Lets you to make your wishes known.
  • Provides an opportunity for you to involve your family in the decisions.
  • Releases your family of the financial burden presented by an unexpected funeral.
Funeral services include:

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  • Professional services of a funeral director and staff
  • Transportation services
  • Embalming and other preparation
  • Facilities for visitation
  • The funeral ceremony
  • Funeral vehicles
  • Other services and associated items including pastoral services and music

Funeral merchandise includes:
Caskets, Urns, or Burial Vaults
Casket ranging from $495.00 to $7950.00
Burial Vaults ranging from $795.00 to $2880.00
Other merchandise and associated items such as flowers and acknowledgment cards.

By Preplanning your funeral
 Your loved ones will be relieved of making difficult decisions at a time of high stress.
Your funeral will reflect your desired wishes.
Your thoughtfulness alleviates a financial burden on your family.
Your funeral arrangements can be fully funded. This way,once you have made all your payments, no additional money is ever needed...providing you with protection against future price increases.
These plans need to be complete and concise, updated as changes occur, and documented at our Funeral Home to assure accuracy.

Recording your plan...
To assist with your selections, you can schedule an appointment with us or, if that is inconvenient, just complete the Pre-Need form below and we will contact you according to your wishes. Once you've made your decision, tell us exactly what funeral service you wish and we will help you to document it. Then there is no doubt about your desires.

Your loved ones won't need to ask:
Is this what they wanted?
Did we spend too much.....too little?
Did we forget anything?
All that's eliminated because it's in writing.
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:

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:
Funeral Home:
Address: Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:

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

Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Person in Charge of Final Arrangements:
Clothing Preference: My own Other


Disposition Request
I Prefer:
Cemetery:
Address: Phone:
Section:
I have made a last will and testament:     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