Pre-Planning Form

Often when a loved one dies, grieving family members have to grapple with many stressful, emotional decisions about the funeral.

We recommend that you do some investigating BEFORE the need arises, so that you can thoughtfully compare prices and services, and ultimately ensure that the funeral arrangements reflect wise, well-informed, meaningful decisions.

According to the Funeral Home Rule, you have the right to choose the funeral goods and services you want (with some exceptions). Williams Service provides you a written price list which shows the goods and services we offer.
Contact Emma C. Mallisham Williams, a licensed pre-need insurance consultant.

I am planning for:
Personal Information
Name:
Email Address:
Address:
City:
State/Province:
Country::
Zip Code:
Phone Number:
Place of Birth:
Date of Birth:
Sex:
Citizenship:
Marital Status:
Spouse (Maiden Name):
Father's Name:
Mother's Maiden Name:
SSN:
Religous Preference:
Education
High School Name:
# of Years:
College Name:
Family Information: Please list the names of survivors and state their relationship to you, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)
Survivors:
Preceded in Death by::
Additional Information and Organ:
Work History
Occupation:
Business:
Industry:
Company:
Number of Years:
Years Retired:
Military Service
Service Branch:
Serial Number:
Date Enlisted:
Rank at Discharge:
Date Discharged:
Discharge on File At:
Combat Action:
Funeral Preferences
I prefer my Funeral Service to be
Public:
Private:
Visitation
Public:
Private:
Place of Service:
Other:
I prefer
Cremation:
Burial:
Entombment:

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