PRE-PLANNING OF MY FUNERAL/MEMORIAL SERVICE
NAME:_________________ DATE: _______________________
Funeral Home: ___________ Phone: ________________________
Prepaid: yes- _no- _Casket selection: Open __Closed ____
Funeral/Memorial Service held at: Church ______ Funeral Home: ________
Other _____
Number of days of viewing: ____Committal service at: ________
Favorite Hymns:
1.________________________________________________________
2.________________________________________________________
3.________________________________________________________
4.________________________________________________________
Preferred Scriptures:
1.________________________________________________________
2.________________________________________________________
3.________________________________________________________
4.________________________________________________________
Memorial Gifts to: _______________________________________________________
Obituary Information:
Date of birth: ________________ Parents: ______________________________
Survivors: ________________________________________________________
________________________________________________________
_______________________________________________________
________________________________________________________
Special Information and Instructions:
Signed: ______________________ Date: _______________________________
Witness: _____________________ Witness: _____________________________