One of the most loving, caring things that an individual can do is to leave behind details and information in regard to Pre-Planning. If you feel it is too hard to discuss funeral arrangements at this time, just imagine how difficult it would be for your loved ones at a time of loss.

Advantages of Pre-Planning your funeral arrangements:

  • Pre-Planning will express your wishes.
  • Pre-Planning relieves your family from making difficult decisions at a time of emergency.
  • Pre-Planning will give you and your family the security and satisfaction knowing that all the arrangements have been planned and paid for.

Our staff is very qualified and eager to help families in their time of need, as well as helping pre-plan their final arrangements. We offer pre-planned services, and if funded either by trust or insurance, will guarantee your family peace of mind, knowing this has been taken care of for them.

Please call us at (740) 264-4767 if we can be of service to you.

If you are ready to begin your Funeral Planning, you may also fill in the form below:

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