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Carey Hand Cox-Parker Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Carey Hand Cox-Parker Funeral Home.
*Require fields

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
 
Family Member Information

Family Member #1

 
Funeral Arrangement Details
Person in charge of arrangements:
 
Place of service or gathering:
If Other, please specify:

 

Preference for final disposition:
If Other, please specify:
Cemetery:
Disposition of cremated body:
 

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?

 

Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

 
Mary Cook
Born: 10/23/1956
Died: 4/18/2017
Irene DeMartini
Born: 8/24/1918
Died: 3/27/2017
Olive Hebebrand
Born: 10/3/1932
Died: 3/24/2017
Amy Seeley
Born: 5/10/1973
Died: 3/10/2017
Arthur Loyd
Born: 3/17/1924
Died: 3/2/2017
Lucy Benfield
Born: 6/25/1935
Died: 2/27/2017
Mildred Brunson
Born: 3/9/1926
Died: 2/24/2017
Mildred Craig
Born: 10/28/1925
Died: 2/22/2017
Annelle Shupe
Born: 4/17/1930
Died: 2/22/2017

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Carey Hand Cox-Parker Funeral Home | 1350 West Fairbanks Ave | Winter Park, FL 32789 | 407-647-1942
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