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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.

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Harvey Avery, Jr.
Born: 8/12/1927
Died: 7/16/2017
Carmen Flores
Born: 5/29/1930
Died: 7/14/2017
Jane McElyea
Born: 5/8/1928
Died: 7/10/2017
Patty Wofford
Born: 10/29/1954
Died: 7/5/2017
Maurice Jones
Born: 10/6/1921
Died: 7/2/2017
Julia Brooks
Born: 7/11/1928
Died: 6/22/2017
Paul Fulkerson
Born: 10/29/1923
Died: 6/21/2017
Na Nguyen
Born: 1/17/1954
Died: 6/13/2017
Dolores Schmidt
Born: 7/7/1928
Died: 6/13/2017

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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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