Funeral Planning Guide

Funeral Planning Guide

Step 1 of 4

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*
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
Max. file size: 50 MB.

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

To The Entire Draeger-Langendorf Staff-Family,
Joenathan Jr.and I would like to Give Special Thanks to Ms. Lesley for Placing Strength upon Our Hearts, assisting GOD to help US get through this experience. Giving ALL, the Patience, Kindness and Sincere work that was placed into Giving Our Love One, A Beautiful, Home Going Celebration.
Months Later and everyone is still giving Praises to this Beautiful Service.
Gob Bless, Ms. Lesley and the Draeger-Langendorf Entire Staff.
Jonathan Jr. and Charlly (Francere Gholston-Taylor Family)

Charlly Streeter and Family