Service Planning

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Funeral/Memorial Service Preferences
This form contains my personal preferences for your guidance. I do this to assist you in making decisions at the time of my death. Please follow as much as possible:
Today's Date
MM slash DD slash YYYY
Name*
Prefix First Middle Last Suffix
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
I would like to following person(s) to be in charge of arrangements at the time of my death:
1) Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
2) Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email

Personal Information
Marital Status
If married/partnered, to whom:
Prefix First Middle Last Suffix
Date of Marriage
MM slash DD slash YYYY
Children's names and addresses/phone numbers:
1) Child's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
2) Child's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
3) Child's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
4) Child's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
5) Child's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Brothers, sisters, or close relatives names and contact information
Name
First Last
How are you related?
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Parent's full names and contact information if living:
Parent 1:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Parent 2:
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
If veteran, dates, branch, rank:
Occupation(s):
Where
Length of Service
Organizations to which you belong:
Special Awards or honors:
Location of will and/or other important papers:

Funeral/Memorial Service Preferences