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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:

 
Diane Lokken
Born: 12/28/1946
Died: 8/19/2017
David "Duke" Dannheim
Born: 8/7/1955
Died: 8/16/2017
Eulogio Serda
Born: 3/12/1929
Died: 8/12/2017
Eugene Sandoval
Born: 6/11/1967
Died: 8/10/2017
Carolyn Griego
Born: 5/16/1946
Died: 8/8/2017
Robert Harper
Born: 12/29/1935
Died: 8/8/2017
Cassandra Rattie
Born: 4/22/1945
Died: 8/5/2017
Kent Gast
Born: 7/17/1957
Died: 8/3/2017
Merlyn Coulter
Born: 7/9/1949
Died: 7/29/2017

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