Funeral Planning for:

Transcription

1 Funeral Planning for: Please complete this form to the best of your ability -- not all lines need to be filled in. Upon completion, this form will be placed in your membership folder and will be used by the pastor and family upon your death to assist in funeral planning. You may want to keep a copy of this form in a safe place, but not in a safety deposit box. You may want to provide a copy to a family member. Contact the church office if you would like more copies of this form or if you would like to make revisions to your current planning form. 1

2 FUNERAL INFORMATION FORM Full Name: Date: Maiden Name: Address: City, ST, Zip: By preparing a funeral planning guide several things will be accomplished. You will have the assurance that a funeral event will occur and it will meet your personal wishes and requests. You will be providing guidance to whoever your representative will be and establishing cost guidelines for them. You will be clarifying where services and final disposition is preferred, especially important for individuals with multiple places of residency. You will be recording your personal history and vital statistical data that only you may know. Dear Loved Ones, At the completion of my course of life here on earth, I would like my family and friends to use the following information, requests, and suggestions in the plans for my memorial or funeral service. Please read through this entire document before making arrangements for my funeral. Personal Funeral Planning Guide The funeral director will need the following information to complete my death certificate: Date of Birth: Place of Birth: You can find my social security number: Occupation/Retired in from: Kind of business or industry: Military Service: Highest level of education completed: Father s Name (first, middle, last): Mother s Name (first, middle, last, maiden): Place of disposition (name of cemetery, crematory, or other location): 2

3 Notifications Please let all these people know of my death: Spouse - Name/Phone Children - Name(s)/Phone Parents - Name(s)/Phone Siblings - Name(s)/Phone Partner - Name/Phone Friends - Name(s)/Phone Business Associates - Name(s)/Phone Others - Name(s)/Phone Funeral Home This is who I want to handle the arrangements for my funeral: Funeral Home & Location: Funeral Director: Phone: Address: I would prefer (please check the appropriate spaces): Memorial Service, burial preceding Funeral, burial following Memorial Service, cremation preceding Funeral, Cremation following Interment to be public Casket closed Casket open prior to service Casket open during service Casket open following service Interment to be private Preferences for Clothing/ Jewelry: Ideas regarding Casket (wood, metal, colors, open/closed): Ideas regarding Burial Vault or Urn Vault, if applicable: If cremation is chosen, ideas regarding the final placement or disposition of cremated remains: 3

4 I prefer the Memorial or Funeral Service be held at (Please give preference and location of Church, Funeral Home, Cemetery, Chapel, or other location.) Memorial Service or Funeral Service Requests: 1. Preferred Hymns: 2. Is there a specific soloist or musician you would like? 3. Preferred Scriptures: 4. Preferred Poetry: (please attach a copy, if applicable) 5. Preferred Flowers: 6. Personal words to leave: (A brief testimony is often a powerful witness) Please include or attach words you would like to have read at your service. Ideas for a funeral luncheon following the funeral service: Where: Suggested foods to serve: Please have help with the arrangements for the food. Burial: 1. Do you have burial insurance, a pre-arranged and/or pre-paid arrangements made? With whom? 2. Are you eligible for an American Flag as a Veteran? 3. Do you have a cemetery plot? If yes, location: Have portions or all of your body been donated to science? Give details: 4

5 Many loved ones and friends prefer the custom of giving living memorials to a church, a mission organization, school or charity in lieu of flowers. Memorials to be given to: Planned Giving I have included Olivet Lutheran Church in my Will: Yes No I have planned another type of deferred gift: Yes No Please list: life insurance, gift-annuity, charitable trust, etc.: Olivet Lutheran Church is included in my estate plan: Yes No Important Documents Do you have a will? Who has copies? Here s where you can find my last will and testament: The executor of my estate is: My executor s phone number: List of other important documents and their location (birth certificate, marriage license, deeds, automobile titles, insurance policies, pension information, income tax records, banking records, bonds, securities, stock certificates, etc). Location of safety deposit box: Location of keys/combination: 5

6 Obituary Information I am suggesting the following topics for my newspaper or on-line obituary: Birth Date and Birth City/State: The reason for my death may be printed: Yes No Son/Daughter of: My education (schools and degrees): Military Service (branch, rank, dates of service, service number): Military notes (name of war or battle; awards and honors): My marriage to: Date and Place: Date of spouse death, if applicable: My children: My grandchildren: My great-grandchildren: Occupation or places of employment: Achievements, Awards, or Contributions: Fraternal organizations, lodges, or memberships: My hobbies or areas of personal interest: Also, please mention the following: List of the newspapers to submit obituary information to: 6

7 Funeral Homes in the La Crosse area Blaschke & Schneider Funeral Homes 1007 Caledonia St La Crosse, WI Coulee Region Cremation Group 133 Mason Street Onalaska, WI Dickinson Family Funeral Home 1425 Jackson St 809 Gillette 401 Main 515 Mc Hugh Rd La Crosse, WI La Crosse, WI Onalaska, WI Holmen, WI Fossum Funeral Home nd Ave S Onalaska, WI Hanson-Sletten-McKee Funeral Home & Cremation Service 1425 Jackson St La Crosse, WI Jandt-Fredrickson Funeral Home and Crematory 4239 Mormon Coulee Rd La Crosse, WI Jandt-Fredrickson Funeral Home 121 N. Youlon 102 Hattan St 518 W. Main Street West Salem, WI Bangor, WI Caledonia, MN Schumacher-Kish Funeral Home 200 West Ave S 907 Sand Lake Rd rd La Crosse, WI Onalaska, WI La Crescent, MN Cemeteries French Island Cemetery Mormon Coulee Memorial Park %Catholic Cemetery 2945 S 21 st Pl 519 Losey Blvd. La Crosse, WI La Crosse, WI Oak Grove Cemetery Woodlawn Cemetery 1407 La Crosse St 3636 Mormon Coulee Road La Crosse, WI La Crosse, WI

8 Sharing the Light and Love of Our Lord Olivet Beacon of Light Lutheran Church 2100 Bainbridge Street La Crosse, WI Church Office: Website: 8