Pre-Arrange Your Funeral

Boydston Funeral Home

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Instructions for the funeral planning form:

Part of funeral planning involves gathering information, which would be needed in the event of a death. This information is used to complete legal paperwork such as death certificate, social security notification, and claims for veterans or insurance benefits. We prepare and send newspaper notices using the information that the family provides. Part of the information you can provide involves personal preferences. We suggest that funeral choices be made with concern for those who would be left to cope with a loss.

The form below is designed to help you gather information. All fields are optional. In other words, you do not have to provide all of the information listed below. If you are not sure or prefer to leave the question blank, just skip to the next item. Once you complete the Funeral Planning form, it can be forwarded to us electronically for safekeeping or you may print it on your own printer to be kept with your records, or you may choose to do both. The information you provide to us is not stored online. We print and keep only a hard copy of your instructions. As always, the information you provide to us is treated with respect and confidentiality. We suggest that you discuss your wishes with your family and loved ones. This helps ensure that your wishes are followed with agreement. This can be difficult to do but well worth the effort in providing care for your loved ones.

Your Funeral Planning Form

I am planning for

Personal Information

Name - (First, Middle Initial, Last):

Social Security Number:

Date of Birth:

Date of Death:

Place of Birth:

SEX:

Address:

City:

County:

State:

Zip:

Phone:

E-mail:

Spouse's Name:		Spouse's Maiden Name:
Place of Marriage:		Spouses Date of Death:
Date of Marriage:		Spouses Place of Death:
Father's Name:		Mother's Name:
Mother's Maiden Name:

Work/Education History

Education Level:

Primary:

Secondary:

Occupation:

Business:

Industry:

Company:

Number Of Years:

Other Educational and Occupational Information:

Military Service
Service Branch:		Serial Number:
Date Enlisted:		Rank At Discharge:
Date Discharged:		Discharge On File At:
Wars, Actions, and Honors Received:

Funeral Preferences

I Prefer My Funeral Service To Be: (Please Check One) Public or Private

Place Of Service:

Religious Denomination:

Place Of Worship:

Name:

Special Services Requested:
Masonic

Military Honors

Other

Pallbearers Names:

Alternative Pallbearers Names:

Instructions for the Funeral Service
Musical Selections to be Used:
Vocalists:	1. 2. 3.
Organist or Pianist:
Other Musical Requests:
Favorite Bible Passages:
Favorite Literature Or Poems:
Favorite Flower(s):
Favorite Flower Color:

Final Disposition
Preference for final disposition is:	Ground interment with
	Mausoleum entombment
	Cremation with
Preference of cemetery or mausoleum is:
Address:
A is owned at the above location

Special Instructions

Person To Finalize Arrangements At Time Of Death
Name:
Relationship:
Address:
City:	State:	Zip:
Phone:	E-mail:

Send me information on pre-arrangement
Contact me to set an appointment
Keep my information on file

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