Pre-Arrange Online

When you pre-plan your funeral, you give your family a wonderful gift…the freedom from having to make important decisions at the most difficult time. Pre-planning is also the best way to personalize a funeral, by making your wishes known far in advance…during times when you can more easily reflect on what kind of service you would like your family to experience.

If you choose to pre-pay, you also relieve your family of the possibility of sudden, unexpected expense. In New York, pre-planning funds are 100% trusted, which is required by state law.

Our comfortable arrangement room

A pre-funded burial trust is very easy to establish, and your pre-payment may qualify for SSI/Medicaid allowances.

When you discuss your preferences with one of our funeral directors, we’ll have all the information needed to provide exactly the service you specify. This opportunity to pre-plan your funeral, to protect your family, and to have your desires carried out the way you’d like, is an important personal step for you and a precious gift for them.

Contact us about this important matter.

I. Biographical Information
Full Name:
Address1:
Address2:
City Name:
State:
Zip Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
State of Birth:
Highest Education Level:
Please select Grade/Years of Education completed:
   
Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded You In Death
Your Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:
II. Military Record
Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge (DD214):
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:
III. Service Preferences
Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

Miscellaneous Notes and Instructions:

Please select one of the options below:

Please send me information on funeral planning

Please contact me to schedule an appointment

Please place my information on file

 

 

 

190 Main Street | EASTCHESTER, NY 10709 | Phone: (914) 337-4585 | Fax: | Email: cabfoley@optonline.net