First Contact Information
Name:
Address:
City:
Phone:
Email:
State:
Zip:
Place of Birth
Occupation:
Social Security Number:
*This is just for our records and
is not shared with outside resources
Marital Status:
Spouse's Name:
Date of Marriage:
Place of Marriage:
Spouse's Maiden Name:
Father's Name:
Mother's Maiden Name:
VETERAN AFFAIRS
Branch of Service:
War Served In:
VA Serial Number:
Date of Enlistment:
Place of Enlistment:
Date of Discharge:
Rank at Time of Discharge:
Place of Discharge:
EMPLOYMENT INFORMATION
Usual Occupation:
Business Type:
Employer:
Address:
City & State:
Length of Employment:
Retire Date:
SURVIVORS
Spouse:
Number of Children:
Names of children (spouse) City & State: (Separate by comma)
Names of Grandchildren: (Separate by comma)
Number of Great Grandchildren: (Separate by comma)
Number of Brothers/Sisters
Preceded in death by: (Separate by comma)
EDUCATION
High School:
Date Graduated:
College:
Highest Grade Completed:
Degrees Obtained:
AFFILIATIONS
Church Affiliation:
Church Name:
Address:
City:
State:
Organizations, Clubs, Lodges, Hobbies, Etc. (Separate by comma)
PERSONAL PREFERENCES & REQUESTS
Person in Charge of Arrangements:
Clergy (Name)
Pallbearers Names: (Separate by commas)
Type:
Preferences & Special Requests:
Memorials:
Location of Funeral:
Newspapers for Obituary:
CEMETARY INFORMATION
Name of Cemetery:
Other Location:
City:
State:
Section:
Row:
Lot:
Space:
Is there a monument in place:
View Garland Monuments
Garland Monument order#:
SHEET MUSIC / READERS
Organist:
Vocalist:
Song Selections (Separate by comma)
Eulogist:
Reader:
CONTACT PERSON
Name:
Address:
City:
State:
Zip:
Phone:
Email:
Please bring Photos and Clothing for Burial
Comments:
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