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.
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Phillip Arlen Hedgepeth, Jr.
b: Jul 4, 1961 d: Mar 23, 2015
Charlie Harden Cofer
b: Feb 2, 1921 d: Mar 23, 2015
Alton Taylor Clark, Sr.
b: May 1, 1944 d: Mar 23, 2015
Judith M. Smith
b: Feb 2, 1936 d: Mar 20, 2015
Nancy Dixon Roland
b: Jun 3, 1930 d: Mar 20, 2015
John Daniel Tucker
b: Jun 4, 1943 d: Mar 20, 2015
Gayle Orris Paschal
b: Oct 10, 1958 d: Mar 18, 2015
Jessie Ronald Boothe
b: Jan 20, 1948 d: Mar 18, 2015
Margaret "Peggy" Avila Samuels Spor
b: Feb 24, 1922 d: Mar 9, 2015
Garri Ann "Annie" Bateman
b: Mar 12, 1981 d: Mar 18, 2015
Nelson "Buck" Harrison Amburn
b: Apr 29, 1926 d: Mar 17, 2015
John Dillard Gauldin
b: Jun 8, 1933 d: Mar 16, 2015
Cheryl Martin Dunn
b: Mar 23, 1949 d: Mar 16, 2015
Ruth Pratt Lemons
b: Feb 11, 1925 d: Mar 15, 2015
Lonnie Silvers
b: Nov 16, 1931 d: Mar 13, 2015
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


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© 2015 Fair Funeral Home • All Rights Reserved • Website Design By: A Winning Look Creative