Pre-Planning Form

Ruth Yealy

Violet Haar

Patricia Force

Robert Cramer

Wanda Sanders

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Panebaker Funeral Home, Inc.
311 Broadway
Hanover, PA 17331
717-637-5194

Pre-Planning Form

Many people now understand that preplanning your funeral is a precious gift you can give to your family. Since the choices are so personal, and the alternatives so varied, making your decisions well in advance protects your family in two important ways: they will not be faced with complex decisions at a difficult time, and if you prepay, they will never have to bear the burden of unexpected expenses.

Mike and Kristin will personally explain the many types of services that are available, and will ensure that you receive exactly the type of commemorative service you want. They are also able to guarantee that all prepaid arrangements are hedged from inflation.

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 (Maidenn Name):
Father's Name:
Mother's Maiden Name:
SSN:
Religous Preference:
Education
High School Name:
# of Years:
College Name:
# of Years::
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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