Shannon Funeral Service

PRE-NEED QUESTIONNAIRE

We at Shannon Funeral Service would like to thank you for your interest in pre-arranging a funeral service with us.

We have prepared the following information to help you understand all of the important decisions that you will be faced with when pre-arranging a funeral service. The most common question that is asked when discussing pre-arranging a funeral is "Why?" Without a doubt, the most important reasons for pre-arranging your funeral service is to lift that burden from your family at the time of your death or if you are pre-arranging a funeral for one of your family members, it will help in that you won't have as many decisions to make at the time of death when family members are often more emotional. Pre-arranging gives you the opportunity to calmly think through exactly what you want and how you want it, whether it is by telling us through visiting our funeral home, us coming to your home, or by filling out this pre-need questionnaire here on-line.

Pre-arranging also allows you to pre-finance your funeral. Although this is something that is not required, it will only further help to ease the burden on your family at the time of your death. We offer an insurance product that is provided by Investor's Heritage Insurance Company. You may also put funds into the Funeral Funding Trust of Kentucky, which is administered by the PNC Bank in Louisville. This trust fund is very flexible, allowing the consumer to decide how much money they want to put in the trust and when they want to put money in the trust.

If you would like to talk to one of our friendly staff about pre-arrangements and /or pre-funding a funeral of if you just have questions, we invite you to call us at (502) 633-1266 or toll free at 1-(866)-633-1266, and we will help you in any way we can. However if you can't or don't currently feel a need to contact us for any reason, we would encourage you to use our pre-need questionnaire which contains questions about all the information that your family will need at the time of death.

We would like to thank you for letting us serve you.

Personal Information
First Name:
Middle Name(s):
Last Name:
Telephone Number:
E-mail Address:



Address:
Town/City:
State:
Zip Code:
Date of Birth:
Place of Birth: (city&state or County & state)
Marital Status:
Spouses Name: (Maiden name and full name of wife or husband�s full name)
Occupation: (for longest period during working life)
Social Security Number:
Father�s Full Name:
Mother�s Full Name: (include her madien name)

Person who will be in charge of my funeral arrangements:
Name:
Address:
Town/City:
State:
Zip Code:
Telephone Number:
Military Information
Branch of Service:
Description of Service: (Wars fought in, medals earned, military campaigns)
Veteran's Service Number:
Rank
Location of Discharge Papers:
Family Members
Spouse: (Address and phone numbers)
Daughters: (Hometowns and phone numbers)
Sons: (Hometowns and phone pumbers)
Grandchildren: (Hometowns and phone numbers)
Sisters: (Hometowns and phone numbers)
Brothers: (Hometowns and phone numbers)
Other Relatives: (List relation, hometowns, and phone numbers)
My Funeral Service Preferences
Place of Service: (Funeral Home, Church, Graveside, or other)
Clergy: (Minister's hometown and phone number)
Type of Disposition:	Burial Entombment Cremation Other (Describe Below)
Cemetery Property Owned?	Yes No
Name of Cemetery: (Include: Location of Cemetery, City, & State)
Cemetery Preference: (If property not owned, include location of cemetery, city & state)
Music Selections: (Organ or piano background, live vocal, or recorded music) (If live vocal, include the vocalist, and their phone number) (List of songs)
Pallbearers or Honorary Pallbearers: (Include pallbearers hometown, home phone number, and bearer type designation) (A = Active Bearer, H = Honorary Bearer)

Lodge, Society, Fraternal Organization: (List involvement and if you would like an honor guard)
Flowers:
Memorial Contributions / Donations:
Obituary Information: (List education and place of schooling, wedding date and place, work history and places I lived and worked, Clubs, Lodges, Hobbies, what I liked doing, significant accomplishments, Boards, Committees and community and Church involvement, etc.)
Any information or special instructions not previously listed:

Please check as many of the following as apply.
Please contact me so that I may select my casket and vault in advance.
Please forward me a copy of my information for my records.
Please contact me if any of my submitted information needs clarification.
File my information for future reference at Shannon Funeral Service, but please do not contact me.
I would like to discuss my pre-payment options with no obligation, please contact me.


	Home

	Obituaries

	Pre-Need

	Facilities

	History

	Staff

	Contact Us

	Funeral Parlor Talk

	Value of Funerals