Although death is the one inevitable event in our lives, it nevertheless, takes us by surprise, regardless of circumstances. Yet it is a time when we are required to give detailed and accurate information regarding the deceased. This FAMILY RECORD FILE is designed to assist you in gathering the information required to help make funeral arrangements.

Once completed, please click the submit button and it will be electronically sent to our office.













Marital Status

Personal Information:





Living Relatives (children, grandchildren, parents, grandparents, brothers, sisters, etc.)


Deceased Relatives (children, grandchildren, parents, grandparents, brothers, sisters, etc.)

Veteran Information:




dates of service:
to 

Educational Information:

Highest Degree Obtained 




Religious Service Information

This section gives us a bit of personal information that may be helpful in determining specific details about the type of funeral or memorial service, burial options, and so on that you desire.

I would like the following religious convictions expressed:



Some of the accomplishments I am most proud of are:


One of my fondest memories, greatest pleasures, or most delightful activities has been:


My favorite scripture, quote, poem, etc.:


My favorite music, hymns, lyrics, etc.:

Service Instructions

The following questions are specific instructions for your funeral arrangements. Please consider these carefully and discuss them with relatives and friends. If you have any questions, please make note of them and we will be sure to answer you as quickly as possible.

Visitation and Funeral/Memorial Service:


Funeral Home/Church/Graveside:


Would you prefer:
         public viewing  private viewing

Would you prefer:
         open casket     closed casket

Burial Container:


Would you prefer:
         burial  cremation  entombment

Cemetery Lot Description:


Notes:


Questions: