Biographical Information Form

The Biographical Information Form is used primarily as a guide for the family and the funeral director at the time of funeral arrangements. Information that you provide to us is confidential and non-binding. This information will remain on file at the funeral home until the time of need.

Name/Location:
First Name:
Middle Name:
Last Name:
Address:
 
P.O. Box:
City:
State: Zip:
Birth Date:
Birth Place City: State:
 
Parents:
Father's First Name:
Father's Last Name:
Mother's First Name:
Mother's Maiden Name:
 
Education:
Total Years of Formal Education:
Elementary School Attended: Year Graduated:
High School Attended: Year Graduated:
College Attended: Year Graduated:
 
Military Service:
Service to Our Country? Yes No
Branch of Service:
Dates: -
 
Personal Information:
Employment History:
Achievements:
Church Member/Involvement:
Organizations:
(example: VFW)
Special Interests:
Hobbies:
Favorite Flower:
Favorite Songs:
 
Surviving Family:
Surviving Spouse:
Surviving Children:
(Youngest to Oldest)
Name Spouse City State
Number of Grandchildren:
Number of Great Grandchildren:
Brothers and Sisters:
Name Spouse City State
Immediate Family:
(who has preceded you in death)
Name Relationship
 
Additional Information:
Name of Cemetery:
Additional Instructions:
Contact Person:
Phone Number:
For your information -
The following items will
someday be needed:
  • Good Photograph
  • Full Clothing
  • Jewelry/Eyeglasses
  • Rosary (Catholic)
  • Veterans Discharge Papers (DD-214)