Walker Family Funeral Services Inc. Advanced Planning

Making It Easier ~ A practical & thoughtful gift for those you love and care about. Pre-planning funerals is a growing trend in America because of the peace of mind that comes from having one’s affairs in order. Funding those arrangements with insurance coverage locks-in today’s cost and guarantees price will be fixed for the future. Anyone to age 99 may apply, and there is no medical examination necessary; only a simple questionnaire after the advance plans are made. NOTE: all insurance funded Pre-Need/Advance Plans are fully transferable anywhere within the U.S. and we honor all competitive Pre-Plans often resulting in a return of excess funding. Feel free to give us a call or schedule a time that is convenient for one of us to meet with you.

To speak or meet personally with Gregg Walker, Licensed Funeral Director & Pre-Need Planner, feel free to contact him via any of the means within our site.

**Personal Information**
Name (First MI Last):
Marital Status:
Date of Birth:		Place Of Birth:
Address:
City:		State:
County:		Zip:
Phone:		E-mail:
Spouse's Name:		Spouse's Maiden Name:
Place of Marriage:		Date of Marriage:
Father's Name:		Mother's Name:
Mother's Maiden Name:

Person in Charge:
Address:
Phone:

***Work/Education History***
Education (0-12):		College 1-5+:
Occupation:
Business:		Company:

***Military Record***
Branch of Service:		Serial Number:
Date Enlisted:		Rank At Discharge:
Date Discharged:		Discharge On File At:
Copy of Discharge Papers: Yes No
Name Of Wars:

**Funeral Service Request**
Place Of Service:
Funeral Home:
Address:		Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:

***Newspaper Information (Please list family members)***
Children:
Brothers/Sisters:
Number of Grandchildren:
List any other significant relatives:

**Special Instructions**
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Person in Charge of Final Arrangements:
Clothing Preference:	My own Other

***Disposition Request***
I Prefer:
Cemetery:
Address:		Phone:
Section:
I have made a last will and testament: Yes No
Location:

***Other Instructions***

**Memorials/Donations To Charity**

**Please select all that apply:**
Send information about pre-arrangement Contact me to set an appointment Please keep my information on file