Madison Funeral Home | Pre-Arrange

Pre-Arrangements…

Planning ahead provides you with:

Peace of mind
Guaranteed funeral services
Protection from rising costs

For more information call us at 828-649-9163

…or send this form

Your Name* Title

First Name Middle Name Last Name

Address Street
City
State
Zip

eMail & Phone* eMail
Phone

Personal Information Social Security
Date of Birth
County of Birth
Father's name
Mother's Name
Mother's Maiden Name
Marital Status
Spouse
Maiden Name
Marriage Date

Education & Career Education (years)
Occupation
Business
Company

Military Service Branch of Service
Serial Number
Date Enlisted
Rank at Discharge
Date of Discharge
Discharge on File at

Do you have a copy of
your discharge papers Yes No
Name of Wars
Person in Charge
Person in Charge Address
Person in Charge Phone

Insurance Information Insurance Information (if Applies)

Final Arrangements Place of Service
Place of Service Address
Place of Service Phone
Place of Visitation
Religious Denomination
Member/Attend what Church
Service Music

Pallbearers Pallbearer 1
Pallbearer 2
Pallbearer 3
Pallbearer 4
Pallbearer 5
Pallbearer 6

Jewelry
Glasses
Clothing
Other
Disposition Request
Preference Earth Burial, Mausoleum, Niche, Etc.
Address
Phone
Section
Memorials / Donations to Which Charity
Other Comments or Instructions

Request Further Assistance

Send information Yes No

Contact me to set an appointment Yes No

Please keep my information on file Yes No

*…indicates required items

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think about it…

Pre-arranging a funeral serves three important purposes.

1. Peace of Mind. The pre-selection of a funeral home eliminates efforts to search for one at the last minute. The funeral home will know what to do at the time of your death, and your family will know who to deal with and what to expect. Pre-arranging a funeral spares your survivors the burden of making last minute decisions. Death brings with it grief, confusion, and uncertainty. Under these circumstances, it becomes difficult for survivors to make the best decisions. This may result in delays, much worry and unnecessary expense. Preplanning eliminates unnecessary difficulties in a time of stress and sorrow. It creates comfort and peace for the survivors and gives them the feeling of satisfaction in carrying out your wishes.

2. Guaranteed funeral services. Pre-arranging allows you to determine what type of funeral service and disposition you want. You have time to think about the details and to discuss them with your loved ones. This prepares them in advance for handling your funeral. You will have time to purchase a cemetery plot at a location of your choice, as well as to gather funds and pay for the services, plot, and other goods and merchandise. Preplanning eliminates uncertainties and surprises.

3. Protection from rising costs. If you pre-arrange and prepay, you will be giving your family some financial security and relieving them of any future financial burden. As we all know, we live in a world of constantly rising costs. Locking in your funeral expense now will protect your estate from the uncertainties of the future.

Your Home in Time of Need

Pre-Arrangements…

Planning ahead provides you with:

…or send this form

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think about it…