There are only two ways to live your life. One is as though nothing is a miracle.
The other is as though everything is a miracle.    - Albert Einstein
Pre-Planning Information Form

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Why Pre-Plan? the subject of funerals is never an easy one to discuss, The death of a loved one and the limited amount of time to attend to all the necessary details leaves many families overwhelmed. Exploring the options and taking the time to pre-arrange your funeral can alleviate many of the financial and emotional burdens your loved ones may face at the time of your death. Pre-planned funerals may be part or fully pre-paid, funded by insurance or paid by your estate or your next of kin at the time of need. Here are some important questions to ask yourself:

If I were to die tomorrow:

  • who would be responsible to arrange my funeral?
  • What would I expect my funeral costs to be and where would the money needed to pay for my funeral come from?
  • Where would I like my final resting place to be and what type of service would I prefer; i.e. earth burial, entombment or cremation?
To help you, we have included a form that you can easily fill-out to receive more information on pre-planning.

I. Biographical Information
Full Name:
Address1:
Address2:
City Name:
Province:
Postal Code:
Telephone Number:  (xxx-xxx-xxxx)
Email Address:
Date of Birth:  (MM/DD/YYYY)
City of Birth:
Province of Birth:
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded You In Death
Your Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:
II. Military Record
Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (MM/DD/YYYY)
Date of Discharge: (MM/DD/YYYY)
Rank at Discharge:
Location of a Copy of Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:
III. Service Preferences
Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

Miscellaneous Notes and Instructions:


Please select one of the options below:

Please send me information on funeral planning

Please contact me to schedule an appointment

Please place my information on file