Funeral Planning Form

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					                              Funeral Planning Information for My Family

Personal Information

Full Name:


City, State, Zip:

Place of Birth:                                          Date of Birth:

Country of Citizenship:                                  Social Security Number:

Spouse’s Name:                                           Maiden name:

Religious Affiliation:                                   Place of Worship:


High School:                                             Institution:

Undergraduate Degree:                                    Institution:

Graduate Degree:                                         Institution:

Career Information

Employed as:                                             How long?

Employed as:                                             How long?

Employed as:                                             How long?

Military Information

Serial Number:                                           Rank:

Branch of Service:                                       War Service?

You may be entitled to full military honors in one of the national cemeteries. There is no charge for services of
burial and your spouse may qualify as well. Check with the Veterans’ Affairs Department Office; toll free at 800-
827-1000. Please note that discharge papers are necessary to file for benefits.

Other Activities

Involvement in community or national organizations, clubs, affiliations, volunteering:

Favorite pastimes, hobbies: 1-800-696-6077                                                                                    1

Father’s name:                Place of Birth:

Mother’s name:                Place of Birth:


Name:                         Name:

Address:                      Address:

Phone:                        Phone:

Special Instructions:         Special Instructions:

Name:                         Name:

Address:                      Address:

Phone:                        Phone:

Special Instructions:         Special Instructions:


Name:                         Name:

Address:                      Address:

Phone:                        Phone:

Special Instructions:         Special Instructions:

Name:                         Name:

Address:                      Address:

Phone:                        Phone:

Special Instructions:         Special Instructions: 1-800-696-6077                           2
Funeral Planning Form
             Final Arrangements for: ______________________________________

Memorial Services
Funeral home:

Funeral director:

Location of service:

Pastor to Officiate:

Military/fraternal/social organization or lodge members to be present:


Veteran’s flag:                        Draped on casket

Special Hymns:

Scripture selections:

Flowers:            Yes           No

                          Yes           No
Name of charitable organization:

Casket:         Open                              OR
Preparation and printing of the order of memorial services (usually provided as part of service by funeral director
with assistance from family):

Name, address, and phone of cemetery:

Cemetery documents located:

Casket:         Wood                                   Steel
                           Bronze        Copper
Burial Vault (usually required by cemetery/may be purchased through funeral home or cemetery-check on pricing):

Property or crypt
purchased?                      Yes          No 1-800-696-6077                                                                                      3

No. of spaces:

Type of burial:        Earth burial   Crypt        Mausoleum       Other:
Inscription to read:

Clothing to wear/glasses/hair/Bible in hand:

Baptism/Holy Spirit:
Date and Location of Water Baptism:

Date and Location received Holy Spirit:

Baptized in water by:

Life Insurance Information:
Company/Policy Number:
Company Phone Number:

Company/Policy Number:
Company Phone Number:

Message to my Loved Ones:

Preparing My Obituary

On a separate sheet of paper, make a record of the following information.


Spouse’s name: 1-800-696-6077                                                 4
Date and place of death:

Children/cities where they reside:

Grandchildren/cities where they reside:

Siblings/cities where they reside:

Parents/cities where they reside (or resided, if deceased):

Date, time, and place of funeral or memorial service and burial:

Clergy/person officiating:

Address of funeral home:

Address of cemetery:

Memorial contributions may be made in lieu of flowers to: (optional)

Photo preferred:

Place and date of birth:


Wedding date:

Military service:


Religious affiliation:

Other affiliations:

I respectfully request that the above suggestions be considered as closely as possible in completing my final

Signed: __________________________________________Dated_______________

At:___________________________________State:________ 1-800-696-6077                                                                                     5
                                       Eulogies Honor and Heal

                                   Writing a Eulogy by Garry Schaeffer

Princess Diana had the most publicized funeral in history. It was broadcast worldwide. One of the most
powerful parts was the eloquent and moving eulogy delivered by her brother, Charles Spencer. At one
point he said, "I don't think she ever understood why… there appeared to be a permanent quest on (the
media's) behalf to bring her down…. Of all the ironies about Diana, perhaps the greatest is that a girl
given the name of the ancient goddess of hunting was, in the end, the most hunted person of the modern

Great eulogies make great funerals. Of course, it's absurd to think of a funeral as great, but some are
memorable. Eulogies can be remarkable, moving experiences for speakers and audience members.

You might assume eulogies are as common as flowers at memorial services. Unfortunately, this is not
so. Not all families are able to find someone willing and able to write and deliver a eulogy. Some
funerals do not have them; others rely on clergy who may not have known the deceased. The results can
be disappointing.

None of us likes to contemplate the loss of a loved one or the call to duty to deliver a eulogy. By reading
this article now, however, you will gain a brighter perspective on this task and discover the rewards of the
writing process as a healing tool.

What A Eulogy Should Accomplish:

There are two common misconceptions about the purpose of a eulogy. Some people think:

    1. It should be an objective summation of the person's life; or
    2. The eulogy should speak for everyone who is present at the       memorial service.

These are unrealistic assumptions.

A eulogy is much simpler. Of course, it will include information about the person's life, but primarily it
should express the feelings and experiences of the person giving the eulogy vis-à-vis the loved one. The
most touching and meaningful eulogies are subjective and written from the heart. A eulogy does not
have to be perfect. Whatever you write and deliver will be appreciated by the people in attendance. If
you are inclined to be a perfectionist, lower your expectations and just do what you can, given the short
time-frame for preparation and your fragile emotional state.

When you set out to write a eulogy, realize the burden does not have to be yours alone. Ask friends and
relatives for their recollections and stories. In a eulogy, it is perfectly acceptable to say, for example, "I
was talking to Uncle Lenny about Ron. He reminded me of the time Ron came to Thanksgiving dinner
with half of his face clean-shaven and the other half fully-bearded. It was Ron's unique way of showing
he had mixed feelings about shaving off his beard."

Be honest. For most people, there are a lot of positive qualities to talk about. Once in a while, however,
a eulogy has to be given for someone with mostly negative traits. If that is the case, omission is the
solution. A eulogy is not a confession. No one will find fault if you leave out negative details. Talk
about positive qualities and, if you must mention the negative, try to put a compassionate spin on it. For
example, "She struggled with her demons and they sometimes got the best of her." 1-800-696-6077                                                                                      6
Tips for Delivering a Eulogy

A eulogy may be the most difficult speech you ever deliver, but it may also be the most rewarding. Calm
yourself by realizing that people are not going to judge you. They will be very supportive. No matter
what happens, it will be okay. If you need to cry in the middle of your speech, everyone will
understand. Take a moment to compose yourself, and then continue. Don't be embarrassed.
Remember, giving a eulogy is a noble gesture that people will appreciate, admire, and remember.

If you can, make the eulogy easy to read. On a computer, print out the eulogy in a large type size. If
you are using a typewriter, put extra carriage returns between the lines. If you are writing by hand, print
the final version in large letters and give the words room to breath by writing on every second or third

Before the memorial service, consider getting a cup of water. Keep it with you during the service.
When you go to the podium, take the water in case you need it. Sipping water before you start-and
during the speech, if needed-will help relax you.

Before delivering the eulogy, breath deeply and remind yourself that you are surrounded by loving friends
and family. They are with you 100 percent. If you would find it easier, read the eulogy without looking
up to make eye contact with the audience. Take your time. Do the best you can. Just be yourself.

Writing as Therapy

Writing in general-a eulogy, a letter, a journal---presents a valuable opportunity to discover a new
therapeutic tool to help you deal with grief, sadness, ambivalence, confusion or other needs for change.
On some level, you already know how therapeutic writing can be. At one time you may have written an
angry letter and not mailed it, but felt better for having written it. In the case of a eulogy, writing brings
up memories, rekindles feelings, and acts as a catalyst. It has been said, "The only way out is through."
Writing helps you revisit emotions that are important to the healing process, so get your feelings on
paper. You do not have to be grieving to use writing as a tool to help you gain clarity on an issue or to
motivate yourself to make changes in your life.

There are many ways to use writing to deal with your loss. Some people keep journals or diaries; others
write letters. Some people send e-mail to friends; others write poems or stories. There is no right
answer. Experiment; Do what works for you.

Julia Cameron, in her book, The Artist's Way, tells aspiring artists to set aside time each morning to
write. She calls it, "morning papers." You can call it, "mourning papers." Every morning take the time
to write three pages of thoughts and feelings. Write longhand---rather than using a typewriter or
computer---because there is a better connection between the hand and the heart. While writing, don't
concern yourself with spelling, grammar, punctuation, being redundant, or making sense. Write half-
baked ideas, thoughts, or feelings if you want. The goal is not to write something good or something that
will ever be read again. The goal is to write simply for the sake of getting it out of your system.

Mourning papers can cover anything---complaints, dreams, frustrations, feelings, and so on. Nothing is
too trivial. Complain about the barking dog next door. Write about your life's dreams or sorrows.
Create a grocery list. Brainstorm goals. Unburden yourself of pain, sorrow, fears, and regrets. You can
think long-term and create a better life for yourself or you can work on immediate needs. The only rule
is there are no rules. Let whatever is on your mind flow onto the paper. 1-800-696-6077                                                                                      7
This is a very powerful exercise during which you will make several discoveries:

            The process is enjoyable.
            Your thoughts will flow quickly and the important ones will be pushed to the surface with
            great force.
            It is easy to fill up three pages.
            You might have to stop to cry, especially if you are mourning or in pain.
            The process frees you of petty complaints and obsessions.
            You will look forward to these morning writing sessions.

Bringing up the pain, although unpleasant, is part of working through it. I'm not a therapist, but from
experience I know that repressing feelings is counter-productive. Shakespeare once wrote, "Tears water
our growth." The power of writing is undeniable and there is no better time than now to take advantage
of it.

Writing and delivering a eulogy is a noble gesture that is worthy of thought and effort. It is an
opportunity to make a contribution to a memorial service-a contribution that you, your friends and family
will long remember. Think of a eulogy as a gift to yourself and others. Embrace the opportunity to
brighten an otherwise dark time.

About the author

Garry Schaeffer is the author of A Labor Of Love: How to Write a Eulogy. This 96-page book includes:

    1. Clear steps for writing a eulogy
    2. Poems for memorial services
    3. Sample eulogies of famous people including Gandhi, JFK, Martin Luther King, Jr., Jackie O., and
       Princess Diana.

The book is available immediately at in electronic and printed versions. 1-800-696-6077                                                                               8