Infinite Menus, Copyright 2006, OpenCube Inc. All Rights Reserved.
Infinite Menus, Copyright 2006, OpenCube Inc. All Rights Reserved.

 

Online Pre-planning Form

There are numerous benefits to pre-planning a funeral, some of which include:
  • Provides peace of mind
  • Relieves your loved ones of unnecessary concern
  • Reflects your expressed wishes
  • Alleviates financial burden on your family

Please take a few minutes to fill out the following pre-arrangement form. A Davis Greenlawn Funeral Home representative will then review your information and will be in touch with you to further discuss the details of your arrangements.


NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence - we do not release any information to outside parties under any circumstances.

Information about person completing the form:

* Last Name:
* First Name:
Middle Name:
* E-mail:
Street Address:
City:
County:
State:
Zip Code:
Phone:
Person for Whom I Am Pre-planning:

Vital Information about the person you are planning for:

Last Name:
First Name:
Middle Name:
Sex:
Marital Status:
Social Security #:
Date of Birth: (ex. 1999)
Place Of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage: (ex. 1999)
Father's Full Name:
Mother's Name:
Mother's Maiden Name:


Work and Education:

Education:
Usual Occupation:
(most of life)
Kind of Business:
Company (Optional):

Military Records:

Branch of Service:
Serial Number:
Date Enlisted:
Rank At Discharge:
Date Discharged:
Discharge On File At:
Copy of Discharge Papers:   YES     NO
Name(s) of War(s)/Conflict(s) Toured:

Funeral Service Information:

Place Of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer The Funeral Service To Be:
Viewing For Family:
Viewing For Friends:
Religious Denomination:
Place Of Worship:
Lodge / Union:

Person(s) To Finalize Arrangements At Time Of Death:

Check here and skip this section if is information is the same as person filling out this form
 
Full Name:
Street Address:
City:
County:
State:
Zip Code:
Phone:

Special Instructions:

Flower Preference:
Music
Casket Bearers (x6):
Jewelry:
Glasses:
Clothing:
Other:

Disposition Options:

I Prefer:
Cemetery:
Address:
Phone:
Section:
I Have Made A Last Will And Testament:   YES     NO


Other Information & Special Instructions:

Please list any other instruction or information you would like us to have:

Memorials & Charities

Please list any memorials or donations to charity that you would like to declare:


Options:

Please select one of the options below:
Send information about pre-arrangement
Contact me to set an appointment
Please keep my information on file

 


© 2006 Davis-Greenlawn and FuneralNet