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Free Planning Notebook

Online Preplanning Form

Online Preplanning Form

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About You

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Your Last Name

Your Phone Number

Your Email Address

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Personal Information

Location of Choice

Who is this plan for?

Their First Name

Their Middle Name

Their Last Name

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Family Information (For the person you are planning for)

Father's Name

Father's Address

Mother's Name

Mother's Address

Marital Status

Spouse's Name

Spouse's Maiden Name

Place of Marriage

Date of Marriage

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Additional Family Members

Siblings (alive)

Siblings (deceased)

Children (alive)

Children (deceased)

Grandchildren (alive)

Grandchildren (deceased)

Great-Grandchildren (alive)

Great-Grandchildren (deceased)

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Education History

School Name

Highest Level of Education

School Location

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Work History

Occupation

Company Name

Years At Company

Did this person serve in the military?

Yes

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No

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Branch

Army

Navy

Air Force

Marine Corps

Coast Guard

Other

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Your Wishes

Visitation Options

Visitation at funeral home checkbox

checkbox

Visitation elsewhere checkbox

checkbox

No Visitation checkbox

checkbox

Funeral Service Option

Funeral service at funeral home checkbox

checkbox

Funeral service elsewhere checkbox

checkbox

No Funeral Service checkbox

checkbox

Reception Options

Reception at funeral home checkbox

checkbox

Reception elsewhere checkbox

checkbox

No Reception checkbox

checkbox

Would you prefer burial or cremation?

Burial

checkbox

Cremation

checkbox

Final Disposition

Ground Interment (burial) checkbox

checkbox

Mausoleum Entombment (above ground) checkbox

checkbox

Columbarium (for cremation urns) checkbox

checkbox

Ashes returned to family checkbox

checkbox

Would you prefer to include a graveside/committal service?

Yes

checkbox

No

checkbox

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Your Preferences

Please list any musical selections you would like to include in your services.

Please list any special themes you would like to include in your services.

Please list any poems, religious texts, or readings you would like to be read at your services.

Please list any specific foods or beverages you would like to make available to your family and guests at the services.

Please list any interests or hobbies you would like to include into your services.

Is there a special story, personal thank you, or message of hope you would like to be read during your services?

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Visit www.prepaidfunerals.texas.gov for information relating to the purchase of pre-need funeral contracts including descriptions of the trust and insurance funding options available under state law.

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