Wallace-Thompson Funeral Homes

Pre-Planning

Your Need...

We all go through life facing decisions and circumstances in which we rely on others, including family and friends, to assist us at our time of need. Early in our lives we look to our parents, teachers, ministers, employers, counselors, bankers and so many others who can provide the necessary service and support for those times of need.

Funeral planning is often difficult for individuals to consider. Many wait until there is an imminent need. We hear families say, "I wish we would have sought help before this happened."

Our funeral homes can assist you and your family in preparing for this time of need. Advance funeral planning is as simple as discussing and recording your wishes. Also, we help those who wish to set aside the necessary funds to protect their funeral funds so the money will not be lost when applying for Medical Assistance. Our advance funeral planning program is offered as a service to benefit families both personally and financially.

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Information about person completing the form:
I am Planning for:
Last Name:
First Name:
Middle Name:
E-mail:
Street Address:
City:
County:
State:
Zip Code:
Phone:

Vital Information about the person you are planning for:
Last Name:
First Name:
Middle Name:
Sex:
Marital Status:
Social Security#:
Date of Birth:	(ex. 1999)
Place Of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage:	(ex. 1999)
Father's Full Name:
Mother's Name:
Mother's Maiden Name:

Work and Education:
Education:
Usual Occupation: (most of life)
Kind of Business:
Company (Optional):

Military Records:
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:

Funeral Service Information:
Place Of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer The Funeral Service To Be:
Viewing For Family:
Viewing For Friends:
Religious Denomination:
Place Of Worship:
Lodge / Union:

Person(s) To Finalize Arrangements At Time Of Death:
Check here and skip this section if is information is the same as person filling out this form

Full Name:
Street Address:
City:
County:
State:
Zip Code:
Phone:

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

Disposition Options:
I Prefer:
Cemetery:
Address:
Phone:
Section:
I have made a last will and testament: YES NO

Other Information & Special Instructions
Please list any other instruction or information you would like us to have:

Memorials & Charities
Please list any Memorials or Donations to Charity that you would like:

Please select one of the options below:

Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file