Pre-arrangements Form | Farus Funeral Home

Online Preplanning Form

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PERSONAL INFORMATION

Full Name

Street

City:

State/Province

ZIP/Postcode

Telephone

Email Address

Date of Birth

Place of Birth

SSN #

Father's Name

Father's Place of Birth

Mother's Name

Mother's Place of Birth

Mother's Maiden Name

Marital Status

Spouse's Name

Spouse's Maiden Name

Place of Marriage

Date of Marriage

Additional Family Members

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Work/Education History

Occupation

Company Name

Business Field

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Military Record

Did you serve in the military?

Yes

No

Did you serve in the military?

Serial Number

Date Entered Service

Rank at Discharge

Date Discharged

Discharge on file at

Do you have a copy of your discharge papers?

Yes

No

Wars Fought In

Person in Charge

Person in Charge Address

Person in Charge Telephone

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Funeral Service Request

Place of Service

Place of Service Telephone

Place of Visitation

Religious Denomination

Place of Worship

Lodge/Union/Assoc. Membership

Person in charge of final arrangements

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Disposition Request

I Prefer

Cemetery

Lot #

Section/Letter

Grave #

Cemetery Address

Cemetery Telephone

I have made a last will and testament

Yes

No

Location of Will

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Summary Details

Additional instructions for us

Memorial requests or donations to charity

Please select from one of the options below:

Send me information about pre-arrangements

Contact me to set up an appointment

No appointment needed just keep my request and information on file

Online Preplanning Form

Online Preplanning Form

Online Preplanning Form

Farus Funeral Home of Duncan Falls

Farus Funeral Home of New Concord