Pre-Planning gives you Peace of Mind and saves you money... Most families we serve are comforted by the knowledge that their loved ones will be spared the hardship of making decisions at such a difficult and sensitive time. In addition, pre-planning allows for pre-financing. This will guarantee the price of the funeral and merchandise selected. 1. Relieve emotion burden from loved ones. 2. Express your own wishes. 3. Relieve a financial burden from those you love. 4. Allows you to make decisions at your own pace without emotional stress. 5. A family can share their choices and decide together.
THE CHOICE IS YOURS
Last Name:
First Name:
Middle Name:
E-mail:
Address:
City:
County:
State:
Zip Code:
Phone:
Vital Statistics
Marital Status:
Never Married Married Divorced Widow Widower
Social Security#:
Date of Birth:
Place Of Birth:
Spouse's Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Work/Education
Education (0-12):
1 2 3 4 5 6 7 8 9 10 11 12
College 1-5+:
1 2 3 4 5+
Occupation:
Business:
Company:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:
Rank At Discharge:
Date Discharged:
Discharge On File At:
Copy of Discharge Papers: Yes No
Name Of Wars:
Funeral Service Info
Place Of Service:
Funeral Home Church Cemetery
Funeral Home:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Lodge / Union:
Person in Charge of Final Arrangements:
Special Instructions
Flower Preference:
Music
Casket Bearers (6):
Jewelry:
Glasses:
Clothing:
Other:
Disposition Request
I Prefer:
Earth Burial Mausoleum Cremation
Cemetery:
Section:
Location:
I have made a last will and testament: Yes No
Other Instructions
Please list any other instructions you may have:
Memorials/Donations
Please list any Memorials or Donations to Charity that you would like:
Options
Please select one of the options below:
Send information about pre-arrangement
Contact me to set an appointment
Please keep my information on file
Branch Funeral Home of Long Island proudly services all areas such as Smithtown, St. James, Nesconset, Hauppauge, Commack, Kings Park, Stony Brook, Lake Grove, Centereach, and all surrounding communities.
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