Funeral Questionnaire

  • Personal Information:

  • Date Format: MM slash DD slash YYYY
  • (City/State or County/State or Country)
  • (Maiden name & full name of wife or husband's full name)
  • (for longest period during working life)
  • (include her maiden name)
  • Person who will be in charge of my funeral arrangements:

  • Military Information:

  • (Wars fought in, medals earned, military campaigns)
  • Family Members:

  • Address and phone numbers
  • Hometowns and phone numbers
  • Hometowns and phone numbers
  • Hometowns and phone numbers
  • Hometowns and phone numbers
  • Hometowns and phone numbers
  • List relation, hometowns, and phone numbers
  • My Funeral Service Preferences:

  • (Funeral Home, Church, Graveside, or other)
  • (Minister's hometown and phone number)
  • (If property not owned, include location of cemetery, city & state)
  • (Organ/piano background, live vocal, or recorded music ~ If live vocal include the vocalists names and phone numbers)
  • (Include pallbearers hometown, home phone number, and bearer type designation) (A = Active Bearer, H = Honorary Bearer)
  • (List involvement and if you would like an honor guard)
  • (List education and place of schooling, wedding date and place, work history and places I lived and worked, Clubs, Lodges, Hobbies, what I liked doing, significant accomplishments, Boards, Committees and community and Church involvement, etc.)