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724-758-4504

For Immediate Need Call:

724-758-4504

500 6TH STREET, ELWOOD CITY PA, 16117

CALL NOW 724-758-4504

ABOUT US
OBITUARIES
TRADITIONAL SERVICES
CREMATION SERVICES
PLAN AHEAD
RESOURCES
MERCHANDISE

Online Preplanning Form

Secure Online Preplanning Form

Online Preplanning Form

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Personal Information

First Name

Middle Name

Last Name

Email Address

Phone Number

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Beneficiary's Personal Information:

Who is this plan for?

First Name

Middle Name

Last Name

Gender

Male

Female

Birth Date

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Family Information

Marital Status

Married

Single

Widowed

Name of Spouse

Maiden Name of Spouse

If deceased, date of death

Marriage Date

Father's Name

Address (if living)

City

State

Zip/Postal Code

Mother's Name

Maiden Name

Address - If Living

City

State

Zip/Postal Code

Siblings (Living)

Siblings (Deceased)

Children (Living)

Grandchildren (Living)

Grandchildren (Deceased)

Great Grandchildren (Living)

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Education / Work

Highest Level of Education

School Name

School Location

Occupation

Company

Years at Company

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Military Service

Yes

No

Years Served

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Service Options

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Visitation at funeral home

I do not wish to have visitation hours

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Funeral Options

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Funeral service at funeral home

I do not wish to have a funeral service

Funeral service at

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Reception Options

New Field:

Reception at funeral home

I do not wish to have a reception

New Field:

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Service Requests

Please list any musical selections you would like to include in your services

Please list any poems, religious texts, or readings you would like to be read at your services.

Please list any interests or hobbies you would like to include into your services.

Please list any specific foods or beverages you would like to make available to your family and guests at the services.

there a special story, personal thank you, or message of hope you would like to be read during your services?

Please list any special themes you would like to include into your services.

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Final Disposition

Burial or Cremation?

Burial

Cremation

Graveside/Committal Service?

Yes

No

Disposition Options

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

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