Online At-Need Funeral Planning

First and foremost, we are sorry for your loss. I know we have just spoken and advised you of this important resource available to you. Although, we have set a time to meet for making arrangements this may help you on this journey. Quite often families making arrangements will forget some detail that is important. Filling out this online form provides us with every piece of information we would need. It also insures nothing has been overlooked. We recognize you may not know everything right at this moment, but what you do know will be invaluable.

The following questions provide the information necessary to prepare a record of your vital statistics to be used for preparing the obituary and any legal documents. The information you submit is being transmitted via encrypted email, will be held in the strictest confidence, and will not be shared with anyone.

I. Biographical Information

Your Name:

Your Email:

Contact Phone Number:

Family Online Contact:

Chapel Location:

All of the following questions will relate to the person for whom this arrangement is being made.

Full Name:

Address

Address:

City:

Country:

State/Province:

Zip/Postal code:

Telephone Number:

Email Address:

Marital Status:

Date of Birth:

City Of Birth:

State of Birth:

Highest Education Level:

Please list schools, years of attendance and any activities or clubs:

Residence History, where you were born, raised, relocated and retired (if applicable):

Father's Name:

Fathers City of Residence unless deceased:

Mother's Name:

Mother's City of Residence unless deceased:

Mother's Maiden Name:

Spouse's Name:

Spouse's Maiden Name:

Survivors' Names (Spouses) and Cities of Residence i.e. John (Jane) Jones of Morris, Il:

Relatives Who Have Preceded You In Death:

Your Occupation:

Business Type:

Company Name:

Church Membership:

Lodge or Union Name:

Clubs, Organizations or Hobbies you are proud of:

II. Military Record

Veteran:

Branch of Service:

Serial Number:

Date Enlisted:

Date of Discharge:

Rank at Discharge:

Location of a Copy of Discharge (DD214) or email to discharge@fredcdames.com:

Upload a Copy or Photo of Discharge Papers:

Time of Military Service:

Military Honors at Graveside:

Flag Preference for Service:

There is no substitute for a discussion with a funeral director as it relates to the impact of making a healthy grief recovery for your family and the selection of a service. With that said, most families have an idea of what they would prefer. Please indicate below what best describes your thoughts for arrangements.

III. Service Preferences

Type of Service:

Detailed Service Description:

Visitation Hours:

Funeral Merchandise: There is a variety of products and manufacturers for Caskets, Rental Caskets, Outer Burial Containers, Burial Vaults, Cremation and Personalization Products available at almost every price point. Selection is always a personal decision and should be made with financial considerations at heart, personal preference and good information.

Person in Charge of Arrangements:

Officiating Clergy:

Pallbearers (if applicable):

Flower Preference:

Music Selection(s):

Jewelry:

Glasses:

Cemetery Name:

Cemetery Location:

The cemetery Deed or Property Ownership is in the name of:

Your Grave number, Lot number, Section Number and you will be next to:

Funeral Luncheon? Thinking about a gathering afterwards?:

Miscellaneous Notes, Instructions or anything you wish to add:

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