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On-line Pre-planning Form

There are numerous benefits to pre-planning a funeral, some of which include:

Provides peace of mind
Relieves your loved ones of unnecessary concern
Reflects your expressed wishes
Alleviates financial burden on your family

Please take a few minutes to fill out the Online Pre-planning Form, below. Once submitted, a Brazos Funeral Home representative will then review your information and will be in touch with you to further discuss the details of your arrangements.

If you'd rather fill out a printed version of the form,
you can download this form by clicking here

NOTE: It is recommended to right-click the link above and choose to save the PDF to your local computer where it can then be opened with Adobe's Acrobat Reader. If you don't already have the Reader installed on your computer, it is available for free from Adobe's website - please click the icon at right to be taken to the download page.

Mail completed forms to this address:
1124 Washington Avenue
Waco, Texas 76701
Please call with any questions: 254-755-6636

NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence - we do not release any information to outside parties under any circumstances.
Information About The Person Completing This Form:
* First Name:
* Last Name:
Middle Name:
* E-mail:
Street Address:
City:
County:
State:
Zip Code:
Phone:
Person for Whom I Am Pre-planning:

Vital Information About The Person For Whom Pre-planning Is Being Done:
Last Name:
First Name:
Middle Name:
Sex:
Marital Status:
Social Security #:
Date of Birth:	(ex. 1999)
Place Of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage:	(ex. 1999)
Father's Full Name:
Mother's Name:
Mother's Maiden Name:

Work and Education:
Education:
Usual Occupation: (most of life)
Kind of Business:
Company (Optional):

Military Records:
Branch of Service:
Serial Number:
Date Enlisted:
Rank At Discharge:
Date Discharged:
Discharge On File At:
Copy of Discharge Papers:	YES NO
Name(s) of War(s)/Conflict(s) Toured:

Funeral Service Information:
Place Of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer The Funeral Service To Be:
Viewing For Family:
Viewing For Friends:
Religious Denomination:
Place Of Worship:
Lodge / Union:

Person(s) To Finalize Arrangements At Time Of Death:
Check here and skip this section if is information is the same as person filling out this form

Full Name:
Street Address:
City:
County:
State:
Zip Code:
Phone: