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Brown-Dugger Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Brown-Dugger 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:

 
Richard Pitts
Born: 1/21/1964
Died: 6/18/2017
Hazel Allen
Born: 4/20/2017
Died: 6/17/2017
Linda Schwandt
Born: 7/14/1939
Died: 6/2/2017
Gareth Austin
Born: 6/10/1950
Died: 5/29/2017
Betty Taber
Born: 5/27/1929
Died: 5/26/2017
Dolores Campbell
Born: 4/18/1929
Died: 5/7/2017
Regina Webb
Born: 3/4/1950
Died: 5/4/2017
Sheila Warner
Born: 3/6/1936
Died: 4/30/2017
Karel Moore
Born: 6/8/1939
Died: 4/29/2017

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