Pre-Planning Form Life This will help you collect what's needed so nothing is left out. Legal NameTitleFirst Name *Middle NameLast Name *SuffixLast Name at BirthPreferred NameVeteranYesNoVeteran InformationPrimary Branch of ServiceSelect OneAir ForceArmyArmy Air ForceCoast GuardMarinesMerchant MarinesNational GuardNavySelected ServiceOtherMilitary Serial NumberVA File NumberPlease Specify Branch of ServiceMost Recent RankingDate of EnlistmentPlace of EnlistmentStatusService Connection Death?Served in Reserves?Served Under Alternate Name?YesNoFirst NameMiddle NameLast NameService RenderedTours of DutyTours of DutyTour of DutySelect a TourWorld War IIKorean WarVietnam WarGulf WarWar in AfganistanIraq WarMilitary Intervention Against PeacetimeWorld War IOtherTour of Duty NamePrimary Branch of ServiceSelect OneAir ForceArmyArmy Air ForceCoast GuardMarinesMerchant MarinesNational GuardNavySelected ServiceOtherRankSerial NumberPlease Specify Branch of ServiceDate EnteredDate ReleasedPlace EnteredPlace ReleasedDischargeDate of DischargePlace of DischargeHonorable DischargeDD-214 Discharge Papers AvailableAddressAddress Line 1Address Line 2CityStateZIP CodeCountyCountryInside City Limits?YesNoBirth InformationDate of BirthBirth CityBirth StateBirth CountryPersonal InformationGenderSelect a GenderMaleFemaleMarital StatusSelect a StatusNever MarriedSeparatedMarriedCivil UnionCommon LawWidowedRaceSelect a RaceAfrican AmericanAlaska NativeAmerican IndianAsian IndianBlackChamorroChineseFilipinoGuamanianJapeneseKoreanNative HawaiianOtherOther AsianOther Pacific IslanderSamoanVietnameseWhiteEthnicitySelect an EthnicityHispanic: CubanHispanic: Mexican, Mexican American, ChicanoHispanic: OtherHispanic: Puerto RicanNot Hispanic, Latin, or SpanishCitizenshipEmployment HistoryLevel of EducationSelect a Level8th Grade or Less9th-12th Grade, No DiplomaAssociate's DegreeBachelor's DegreeCollege Credit, No DegreeDoctorateOccupationIndustryEmployerParents ParentFirst NameMiddle NameLast NameLast Name at BirthRelationshipFatherMotherStep-fatherStep-motherBirth CountryDeceased?YesNoDate of DeathPlace of DeathPlace of BurialParentFirst NameMiddle NameLast NameLast Name at BirthRelationshipFatherMotherStep-fatherStep-motherBirth CountryDeceased?YesNoDate of DeathPlace of DeathPlace of BurialFamily Add the family info you'll need for the service, obituary, and paperwork.Family MemberNameRelationPhone NumberPreferences Use the following questions to help you plan a meaningful event. LifeIf you could choose a few words to capture their personality, what would they be? I.e. compassionate, generous, funny.What passions or activities bring them joy? I.e. reading, gardening, photography.What community activities or groups bring meaning to their life? I.e. volunteering, sports, music.Are there colors, animals, or flowers that they love and could bring comfort in remembering them? I.e. butterflies, lilies, or other symbols.When people reflect on their life, what values, lessons, or beliefs do you hope they remember most? I.e. kindness, faith, resilience.Are there specific moments that capture their heart and tell their story? I.e. treasured holidays, or milestones in their personal or professional life.Would you like to incorporate any of these special memories into the memorial event for them? I.e. have someone play or sing their favorite song(s), have family or friends read their favorite poem or scripture.EventHave they expressed wishes for a burial or cremation?BurialCremationI'm not sureOtherPlease SpecifyWould you like a time for family to view the body before the burial or cremation?YesNoI'm not sureWho would you like to attend the visitation?Just immediate familyExtended family and friendsI don't want a visitationI'm not sureWho would you like to attend the memorial event?Just immediate familyExtended family and friendsI don't want an eventI'm not sureDo you have a location in mind for the memorial event? I.e. church, funeral home, special event center.Do you have someone in mind that you would like to facilitate the event? I.e. pastor, friend or family member.Do you have a final resting place in mind? I.e. cemetery or Veterans’ cemetery for burial, mausoleum for burial or cremation, niche for cremation, or another location.Do you have any questions about the planning process that you’d like to discuss with your funeral director?Information about burial vs. cremationPersonalization of the serviceVeteran benefitsCost or paymentOtherPlease SpecifyHow would you like us to contact you?CallTextEmailOtherPhone Number to Call *Phone Number to Text *Email *Please Specify Other Contact Method SubmitPlease do not fill in this field.