Pre Arrange 2

Please complete as much of the information in the form as possible

Name:

First Name:*:

Last Name:*:

Address 1:*:

Address 2::

City/Town:*:

State: *:

Zip:*:

Please select one of the following service package.

Service Packages:

$3,495.00

Basic Casket

Funeral

Basic Burial :

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$5,998.00

Premium Quality Casket

Visitation

Funeral Service

Premium Burial :

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Select Merchandise

Please select a casket for your premium burial package.

$2,995.00

Basic Urn

Funeral Service

Basic Cremation:

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$4,495.00

Superior Quality Urn

Visitation

Funeral Service

Premium Cremation:

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Select Merchandise

Please select an urn for your premium cremation package.

Call or email to arrange in person consultation:

Please contact by:*:

Telephone

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911 Bitter and Sweet

Memory Lane, N. Y.

13640

315-333-5555

We cannot understand bereavement and every individual response to it unless we appreciate how each bereaved person’s world has been forever changed by the loss.

Pre Arrange 2

Personal Information

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