Fowler-Kennedy Funeral Service

Plan Ahead

Many questions will arise when you consider pre-arranging a funeral; questions that can be answered by a funeral director. We can provide the professional guidance and expertise that will answer any questions and help you make informed decisions.

There are many reasons why a person may want to consider pre-arranging a funeral. Primarily, it provides a sense of security. Security in knowing your wishes are known and will be followed; security in knowing that survivors will be relieved of the burdensome decisions that must be made at the time of death; security in knowing you can make choices now that are flexible enough to allow changes and security in knowing that you can finance your funeral preferences in advance.

When you consult with us you are under no obligation to make a purchase or commitment. Our guidance is a service to you. Making arrangements when your emotions are at rest makes good sense.

**Personal Information**
Name (First MI Last):
Marital Status:		Social Security#:
Date of Birth:		Place Of Birth:
Address:
City:		State:
County:		Zip:
Phone:		E-mail:
Spouse's Name:		Spouse's Maiden Name:
Place of Marriage:		Date of Marriage:
Father's Name:		Mother's Name:
Mother's Maiden Name:

**Work/Education History**
Education(0-12):		College 1-5+:
Occupation:
Business:		Company:

**Military Record**
Branch of Service:		Serial Number:
Date Enlisted:		Rank At Discharge:
Date Discharged:		Discharge On File At:
Copy of Discharge Papers: Yes No
Name Of Wars:
Person in Charge:
Address:
Phone:
Insurance Information:

**Funeral Service Request**
Place Of Service:
Funeral Home:
Address:		Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Lodge / Union:
Person in Charge of Final Arrangements:

**Special Instructions**
Flower Preference:
Music
Casket Bearers (6):
Jewelry:
Glasses:
Clothing:
Other:

**Disposition Request**
I Prefer:
Cemetery:
Address:		Phone:
Section:
I have made a last will and testament: Yes No
Location:

**Death Notice & Obituary Information**

**My Special Requests**

**Please select one of the options below**
Send information about pre-arrangement Contact me to set an appointment Please keep my information on file