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Resthaven Gardens of Memory & Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Resthaven Gardens of Memory & 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:

 
Greg Payne
Born: 3/28/1953
Died: 6/19/2017
Paul Carithers
Born: 9/1/1950
Died: 6/18/2017
Michele Zander
Born: 3/30/1962
Died: 6/17/2017
Charles Weyerman
Born: 9/1/1941
Died: 6/17/2017
John Gremillion
Born: 12/4/1922
Died: 6/16/2017
J Lea, Jr.
Born: 7/8/1937
Died: 6/15/2017
Carolyn Richard
Born: 4/9/1926
Died: 6/14/2017
Frances Buckels
Born: 11/13/1925
Died: 6/14/2017
James Logan
Born: 8/23/1946
Died: 6/13/2017

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Resthaven Gardens of Memory & Funeral Home | 11817 Jefferson Highway | Baton Rouge, LA 70816 | 225-753-1440
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