Prearrangements Form – Comeau Funeral Home

Name *

First

Last *

Last

Phone *

Email *

Address *

City

State

Zip Code

Date of Birth

Place of Birth

Number

Father's Name

Father's Place of Birth

Mother's Name

Mother's Place of Birth

Mother's Maiden Name

Dropdown

Spouse's Name

Spouse's Maiden Name

Place of Marriage

Date of Marriage

Additional Family Members

Please use the area above to enter the names of siblings, children and grandchildren.

Education Level

Occupation

Company Name

Business Field

Did You Serve in the Milatary?

Yes

No

Branch of Service

Serial Number

Date Entered Service

Rank at Discharge

Date Discharged

Discharge on file at:

Do you have a copy of the discharge papers?

Yes

No

Wars Fought In:

Person in Charge:

Address

Place of Funeral Service

Funeral Home

Church

Cemetary

Place of Visitation

Religious Denomination

Place of Worship

Lodge/Union/Assoc. Membership

Person in charge of final arrangements

Disposition Request: I Prefer

Earth Burial

Mausoleum

Cremation

Other

Cemetery

Lot #

(if applicable)

Section/Letter

(if applicable)

Grave #

(if applicable)

Address

I have made a last will and testament

Yes

No

Location of Will

Additional instructions for us

Memorial requests or donations to charity

Please select from one of the options below:

Send me information about pre-arrangements

Contact me to set up an appointment

No appointment needed just keep my request and information on file