PrePlanning Form

Please fill in the form below with as much details as you can. This will allow us to better assist you. We will get back to you as soon as we can.

*Name field is required.

Personal Information

Name:
Marital Status:
Date of Birth:		Place of Birth:
Address 1:
Address 2:
City:		State:
Zip:		Country:
Phone:		Email:
Spouse's Name:		Spouse's Maiden Name:
Place of Marriage:		Date Of Marriage:
Father's Name:		Mother's Name:
Mother's Maiden Name:
Informant:
Address:
Phone:

Work/Education History

High School:		College:
Occupation:
Business:		Company:

Military Record

Branch Of Service:		Serial Number:
Date Enlisted:		Rank At Discharge:
Date Discharged:
Participated in Wars:

Funeral Service Request

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

Newspaper Information

Children (names):
Brothers/Sisters:
Number of Grandchildren:
List Any Other Significant Relatives:

Special Instructions

Organizations:
Jewelry:
Glasses:
Person in Charge of Arrangements:
Other Instructions:
Memorials/Donations To Charity:

(616) 837-8161
214 Church St.
Coopersville, Mi. 49404

LeRoy Throop
Director/Manager

Clark Throop
Kenneth Throop
Directors

Recent Obituaries