Funeral Planning Guide

Funeral Planning Guide

Step 1 of 4

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Vital Statistics Record
Name*
Prefix First Middle Last Suffix
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Enter Email Confirm Email
Birthdate*
Date Format: MM slash DD slash YYYY
Birthplace*
Father's Name*
Mother's Maiden Name*
Marital Status*
Marriage Details
Married To
Date
Place
Death Date
Previous Marriage
Married To
Date
Place
Death Date

Personal History
Occupation
Employer
Position Held
How Long
Retired
- Yes
- No
Year
Resident Cities, Year
Education
Lodges, Memberships, Church & Public Office Held
Military
War
Branch
Rate or Rank at Discharge
Enlistment Date and Place
Discharge Date and Place
Service Number
County Recorded
Photograph
Photograph for obituary
- Yes
- No
Upload photograph

Immediate Family
Relationship, Name, City & State
Preceded by
Local emergency contacts to be notified at need
Emergency Contact Name
First Last
Emergency Contact Address
Street Address City State ZIP Code
Emergency Contact Phone
Additional Emergency Contact Name
First Last
Additional Emergency Contact Address
Street Address City State ZIP Code
Additional Emergency Contact Phone

Mike,
Words cannot adequately convey our gratitude for all you did to honor our family member and friend, Mert Fleury. Like with her husband Ray, years ago, you and your staff went above and beyond to help us through this difficult time and to give Mert a wonderful celebration of her life. Every detail was considered, all of our requests were given unfailing attention, and the little extras took our breath away. Every sad feeling and every tear was matched two-fold with feelings of gratitude and comfort because of what you did. We will be forever grateful!
The Fleury Family

David Fleury