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Steed-Todd Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Steed-Todd 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:

 
Vannie Gregory
Born: 8/23/1928
Died: 10/18/2017
Dorothy Bean
Born: 12/18/1920
Died: 10/17/2017
Lawanna Crawley
Born: 11/21/1921
Died: 10/16/2017
Jeffrey Loniewski
Born: 1/12/1971
Died: 10/15/2017
Hazel Granada
Born: 2/2/1929
Died: 10/14/2017
Anna Myers
Born: 5/25/1937
Died: 10/14/2017
Simon Granillo
Born: 8/25/1967
Died: 10/11/2017
Tyler Chitwood
Born: 9/15/1967
Died: 10/7/2017
Larry Davis
Born: 1/13/1956
Died: 10/7/2017

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Steed-Todd Funeral Home | 800 East Manana | Clovis, NM 88101 | 575-763-5541
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