Pre-Plan Online

Pre-Plan Online

Name:

Name at Birth:

Date of Birth:

Gender:

Social Security Number:

Occupation:

Type of Business/Industry:

Residence Address:

City:

State:

Zip Code:

Birthplace:

Marital Status:

Surviving Spouse (Maiden Name):

Ancestry:

Race:

Hispanic Origin:

U.S. Armed Forces Member:

Branch of Service:

Do you have a DD214 form available to provide:

Yes

No

Highest Education:

Father's Name:

Mother's Name

Mother's Maiden Name:

Informant's Name:

Relationship:

Informant Address:

City:

State:

Zip Code:

Home Phone:

Cell Phone:

Email

Preferred Service Type:

Type of Disposition:

Do you want an Obituary?

Published in the Newspaper?

Published on Social Media (Website, Facebook etc.)?

Do you want a photo to accompany the Obituary?

Obituary:

Do you have any Personal Preferences?

Interests/ Hobbies:

Love Note:

My Passions, My Dreams:

My Legacy:

My Favorite Memories:

My Favorites:

My Favorite Music:

My Favorite Quote, Psalm, Scripture:

Survivors:

Preferred Quotes/Psalms:

Music Prederence:

Do you have a preferred Officiant?

Do you have a preferred or arranged cemetery?

Pallbearers:

Attach Photo

White Salmon

P.O. Box 2699

156 NE Church Ave.

White Salmon, WA 98672

Goldendale

PO Box 134

300 W. Broadway

Goldendale WA, 98620

Admin | Obittree | Privacy Policy | Terms of Use | Sitemap | Powered by FrontRunner Professional

Share by: