Pre-Planning Form

Perrsonal Information
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Personal Information

I am planning for:

Name*:

Please enter the complete name for the person this is for

Email Address:

Address

Address:

City:

Country:

State/Province:

Zip/Postal code:

Phone:

Place of Birth:

City, State - Place of Birth

Please enter the date of birth for the person this is for

Date of Birth*:

Sex:

Male

Female

Please enter the gender of the individual this is for

Citizenship:

Martial Status:

Please list your current martial status.

Spouse Name:

If Married, Please enter the name of the Spouse

Spouse living?:

Maiden Name:

If Married, Please enter the maiden name for the wife

Father's Name:

Please enter fathers name

Father living?:

Mother's Name:

Please enter mothers name

Mother living?:

Religous Preference:

Education

Number of School Years Completed:

High School & Graduation Year:

College/Unversity & Graduation Year/Name:

Other:

Please list the names of survivors and state their relationship to you, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)

Family Information

Survivors:

Preceded in Death by:

Additional Information:

Work History / Memberships

Occupation (Cannot Be Retired):

Industry:

Employer:

Year of Retirement:

Memberships:

Other:

Military Service

Service Branch:

Awards/Citations:

Date/Placed Enlisted:

Rank at Discharge:

Date/Place Discharged:

Discharge on File At:

Type of VA Marker:

Service Preferences

Funeral/Memorial Service Type:

Viewing/Visitation Type:

Place of Funeral/Memorial Service:

Place of Viewing/Visitation:

I Prefer:

Embalming

Cremation

Check all that apply.

Disposition:

I would like to be contacted by a funeral director at Frain Mortuary:

Yes

Preferred method of contact:

Other:

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Pre-Planning Form

Perrsonal Information

Family Login

Address

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Pre-Planning Form

Perrsonal Information

Family Login

Address

Who we are

​contact us

​quick links

Connect With Us

contact us

quick links