Page 2 - Funeral Planning Guide
P. 2

My Personal History




                      Your family will be consoled knowing they are fulfilling your final requests.



                                             Responsibility to Those I Love...
                            Help simplify matters by providing pertinent details to family members.
       A will is typically read after the funeral and is not the best place to indicate your funeral wishes.



      PERSONAL INFORMATION


      Date:                                                   Social Security Number


      First Name                              Middle                              Last


      Date Of Birth                 Birthplace (City, County, State)


      Current Address                                           City                          State     Zip

      Phone Number                Cell Number                 Work Number                 Email Address


      Marital Status (Check One)    Single    Married    Widowed    Divorced   Race/Nationality

      Spouse’s Full Maiden Name                           Marriage Date           Place              Date Of Death (If Applicable)

                                                      Y      N                                                Y      N
      Father’s Name                                   Deceased   Mother’s Maiden Name                           Deceased
                                                      (Check One)                                               (Check One)



      PROFESSIONAL INFORMATION










      EDUCATION                                                 COMMUNITY AFFILIATIONS


      Education Level Completed                                 Lodges, Memberships & Public Offices Held


      High School Attended                                      Awards & Certifications

      City, State, Year Graduated                               Hobbies & Interests


      College Attended                                          Church (Name, Denomination, Involvement)

      City, State, Year Graduated


      Degree(s) Received                                        Charities/Volunteerism

      Awards Received
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