Preplan a Funeral in Ballwin, MO | Schrader Funeral Home & Crematory

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YOUR INFORMATION

Your Name*

Your Mailing Address*

Your Email*

Your Phone*

I am planning ahead for...*

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VITAL STATISTICAL INFORMATION:

The following information will be needed for completion of files and records

FULL name of person you are preplanning for*

Their Street Address*

Their City/State/ZIP*

Their Social Security Number (last 4 digits)

Their Date of Birth*

Their Place of Birth (City, State)*

Their Marital Status*

Their Significant Other's Full Name (including Maiden, if applicable)

Their Father's Full Name

Their Mother's Full Name (including maiden name)

Their Highest Level of Education Completed (years)

Their Occupaton (cannot use "retired")*

Kind of Business or Industry

Are They A Veteran of US Armed Services?*

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FUNERAL AND/OR MEMORIAL CEREMONY DETAILS

Disposition Preference*

Cemetery Name

Cemetery or Crematory Name with City and State if not local to us

Type of Ceremony*

Location of Funeral or Ceremony*

Viewing of Body?*

Location of Visitation or Gathering*

Newspaper Obituary?

List Family Members and Spouses for obituary

Type of Casket

Type of Vault (Outer Container)

Type of Urn

Charity for Memorial Contributions

Use this space to list any other important information

Prepayment Options

Is qualifying for Medicaid a consideration?

Pre-Planning Form