Fair Funeral Home

Pre-Planning

Pre-planning your funeral arrangements can help prevent family disputes and foster a sense satisfaction to your family. They will know that they are fulfilling your final wishes and this can bring a sense of peace in what can be a very difficult time.

You can download the Fair Funeral Home Pre-planning Form by CLICKING HERE.

Or, you can complete our online pre-planning form and a copy will be sent to you and one will be kept on file for our records.

Click Here For Online Pre-Planning Form

Personal Information
Today's Date:
Email:
Name: Maiden Name If Applicable:
Street Address:
City: State: Zip:
Social Security No.:
Sex: Male Female
Race:
Marital Status: Single Married Divorced Separated Widowed
Place Of Birth: City County
Spouse's Name: Maiden Name, If Applicable:
Spouse's Address: Click Here If Same As Above, Else
City: State: Zip:
Father's Name: Living Deceased
Mother's Name: Living Deceased
Maiden Name, If Applicable:
Formal Education: Number Of Years


Survivor Information For Obituary

1st Child: Name: Relationship
Spouse's Name: City: State:
2nd Child Name: Relationship
Spouse's Name: City: State:
3rd Child Name: Relationship
Spouse's Name: City: State:
4th Child Name: Relationship
Spouse's Name: City: State:
5th Child Name: Relationship
Spouse's Name: City: State:
6th Child Name: Relationship
Spouse's Name: City: State:
7th Child: Name: Relationship
Spouse's Name: City: State:
8th Child: Name: Relationship
Spouse's Name: City: State:
9th Child: Name: Relationship
Spouse's Name: City: State:
10th Child: Name: Relationship
Spouse's Name: City: State:
11th Child: Name: Relationship
Spouse's Name: City: State:
12th Child: Name: Relationship
Spouse's Name: City: State:
13th Child: Name: Relationship
Spouse's Name: City: State:
14th Child: Name: Relationship
Spouse's Name: City: State:
1st Brother: Name: City: State:
2nd Brother: Name: City: State:
3rd Brother: Name: City: State:
4th Brother: Name: City: State:
5th Brother: Name: City: State:
6th Brother: Name: City: State:
7th Brother: Name: City: State:
1st Sister: Name: City: State:
2nd Sister: Name: City: State:
3rd Sister: Name: City: State:
4th Sister: Name: City: State:
5th Sister: Name: City: State:
6th Sister: Name: City: State:
7th Sister: Name: City: State:
List Any Other Survivors You Want Listed In The Obituary.
Other Survivor 1: Name: Relationship
City: State:
Other Survivor 2: Name: Relationship
City: State:
Other Survivor 3: Name: Relationship
City: State:
Other Survivor 4: Name: Relationship
City: State:
No. of Grandchildren: List names and address under special instructions if you want the names to appear in the obituary.
No. of Great Grand
Children
List names and address under special instructions if you want the names to appear in the obituary.
No. of Great Great Grand Children List names and address under special instructions if you want the names to appear in the obituary.

Survivor Information For Obituary
Newspapers To Carry Obituary Notice:
Name: City:
Name: City:
Name: City:
Name: City:
Name: City:
Memorial Contributions To:
Name: Address:
Name: Address:
Officer - Club or Professional Organization Memberships:
 
 
 
 
Church: Denomination: City:
Education: List Name of School or College
Name: Degree: Graduated:
Name: Degree: Graduated:
Name: Degree: Graduated:
Name: Degree: Graduated:
Employment Information:
Occupation:
Industry: If Retired, When:
Last Employer: Address: Phone:
Previous Employer: Address: Phone:

Military Record
Branch of Service: Serial Number:
Date Enlisted: Place:
Date Discharged: Place:
Rank: Honors:
Location Of Discharge Papers
Flag Draped Casket: Yes No - If Yes, What Flag:

Funeral Service Request
Type Of Service: Traditional Graveside Memorial
Place Of Service: Funeral Home Church Cemetery
Funeral Home:
Address:
Phone: Fax: Website:
Minister(s):
Body Disposition: Burial Entombment Cremation
Cemetery Name:
Address & Location Of Cemetery Property:
 
Lot & Grave Number: Is A Marker Down? Yes No
Place of Visitation: Funeral Home Church
Visitation Instructions:
Music, Hymns Or Readings You Prefer During Your Service:
 
Special Instructions:
Pallbearers:
 
 
Insurance Policy Information: Policy Provider Policy Number Location
Policy Provider Policy Number Location Policy Provider Policy Number Location
Do You Have A Will?: Yes No
If Yes, Where Is It Located?
  Once this form is completed a copy is emailed to the email address you've entered and a copy is sent to Fair Funeral Home for our records. For more information call us at 336-623-2161 or email us at info@fairfuneralhome.com.
 

This form is ©2012 A Winning Look Creative. All rights reserved. Used by permission.

 



Thomas "Tommy" Henry Wood
b: Sep 15, 1967 d: Apr 15, 2014
David "Lee" Lofton
b: Jun 7, 1939 d: Apr 15, 2014
Helen Beatrice Gilley Bennett
b: Mar 4, 1924 d: Apr 15, 2014
Elaine Joyce Goldston
b: Feb 18, 1918 d: Apr 11, 2014
Sylvia Lucille Ball
b: Apr 15, 1928 d: Apr 11, 2014
James Eugene Smith
b: Sep 28, 1954 d: Apr 8, 2014
Everett Junior Cobler
b: Mar 6, 1928 d: Apr 6, 2014
Gaylord Samuel Worsham
b: No Birth Date Given d: Apr 4, 2014
Betty Jean Isley Rickman
b: Dec 4, 1933 d: Apr 3, 2014
Norman Leo French, Jr.
b: Jun 19, 1931 d: Apr 2, 2014
Emmett Elrine Church
b: Feb 14, 1932 d: Apr 1, 2014
Carolyn Janette Allmon Patterson
b: May 8, 1937 d: Mar 30, 2014
Andrew "Frank" Franklin Rutledge
b: Jul 5, 1937 d: Mar 29, 2014
Gail H. Tucker
b: Oct 14, 1941 d: Mar 30, 2014
Vaughn "Red" P. Grogan, Sr.
b: May 8, 1920 d: Mar 23, 2014
Search Visitation History:
Fair Funeral Home • Address: 432 Boone Road Eden NC, 27288 • Mailing Address: PO Box 337 Eden NC, 27289 • Telephone: (336) 623-2161


Proud Members of the following organizations

   

© 2014 Fair Funeral Home • All Rights Reserved • Website Design By: A Winning Look Creative