Pre-Planning Form

Arnold Davis

Katie Wray

Janet Ford

Angela Enzler

Walter Weaver

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Conner Bowman Funeral Home and Crematory
62 Virginia Market Place Dr.
Rocky Mount, VA 24151
540-334-5151

Lynch Conner Bowman
140 Floyd Ave.
Rocky Mount, VA 24151
Phone: 540-483-5533

Pre-Planning Form

We offer pre-planning at both locations. Regardless if you want to pre-pay or just get some information, we will take the time and sit down with you and see that your wishes are carried through.

All information we obtain from you will be kept in an individual file with your name. This information will then be used at the time of death keeping you from having to go over it again.

As a reminder, Virginia law allows you to transfer pre-funded arrangements from one funeral home to another. We will be glad to assist in such transfer at no cost.

As an added convenience, we will gladly come to your home to make these arrangements. This is a service that we can do now with today's technology. Just let us know, we are here for you!

Benefits

Lets your wishes be known.
Reduces stress for friends and family at an already emotional time.
Saves money
Guarantees your family will never have to pay more for your funeral - no matter what happens with inflation.
Shows you care.
Relieves your loved ones of the financial responsibility.

I am planning for:
Personal Information
Name:
Email Address:
Address:
City:
State/Province:
Country:
Zip Code:
Phone Number:
Place of Birth:
Date of Birth:
Sex:
Citizenship:
Marital Status:
Spouse (Maidenn Name):
Father's Name:
Mother's Maiden Name:
SSN:
Religous Preference:
Education
High School Name:
# of Years:
College Name:
# of Years::
Family Information: Please list the names of survivors and state their relationship to you, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)
Survivors:
Preceded in Death by::
Additional Information and Organ:
Work History
Occupation:
Business:
Industry:
Company:
Number of Years:
Years Retired:
Military Service
Service Branch:
Serial Number:
Date Enlisted:
Rank at Discharge:
Date Discharged:
Discharge on File At:
Combat Action:
Funeral Preferences
I prefer my Funeral Service to be
Public:
Private:
Visitation
Public:
Private:
Place of Service:
Other:
I prefer
Cremation:
Burial:
Entombment:

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