Online Pre-Planning Form

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Chester, NY

845-469-2525

Monroe, NY

845-783-1811

About Us
- About Us
- Our Staff
- Our Locations
  - Chester
  - Monroe
- Testimonials
- Contact Us
Obituaries
- Obituary Listing
- Send Flowers
Services
Planning Ahead
Resources

Send Flowers

800-692-5111

About Us
- About Us
- Our Staff
- Our Locations
  - Chester
  - Monroe
- Testimonials
- Contact Us
Obituaries
- Obituary Listing
- Send Flowers
Services
Planning Ahead
Resources

Online Preplanning Form

Free Text

Personal Information of Deceased

Who is this plan for?

First Name

Middle Name

Last Name

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About You

Email Address

Phone Number

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Family, Work, & Education

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Family Information

Father's Name

Father's Address

Mother's Name

Mother's Address

Marital Status

Spouse's Name

Spouse's Maiden Name

Place of Marriage

Date of Marriage

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Additional Family Members

Siblings (alive)

Siblings (deceased)

Children (alive)

Children (deceased)

Grandchildren (alive)

Grandchildren (deceased)

Great-Grandchildren (alive)

Great-Grandchildren (deceased)

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Education History

School Name

Highest Level of Education

School Location

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Work History

Occupation

Company Name

Years At Company

Did this person serve in the military?

Yes

No

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Your Wishes

Visitation Options

Visitation at funeral home

Visitation elsewhere:

No Visitation

Funeral Service Option

Funeral service at funeral home

Funeral service elsewhere

No Visitation

Reception Options

Reception at funeral home

Reception elsewhere:

No Visitation

Would you prefer burial or cremation?

Burial

Cremation

Final Disposition

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

Would you prefer to include a graveside/committal service?

Yes

No

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