Pre-planning Form

Main menu

If you’d prefer a printer-friendly version of this form CLICK HERE and download to your computer and fill out.

If you have any questions whatsoever, please contact us.

Information about the person completing this form

I am planning for

Last Name *

First Name *

Middle

Street Address

City

State

Zip

County

Phone *

E-mail

Information about the person you are planning for

Last Name

First Name

Middle

Gender

Marital Status

Date of Birth

Place of Birth

Spouse’s Full Name

Spouse’s Maiden Name

Place of Marriage

Date of Marriage

Mother’s Name

Mother’s Maiden Name

Father’s Name

Work and Education

Education (Primary)

College (1-5+)

Usual Occupation (most of life)

Kind of Business

Company

Military Records

Branch of Service

Serial Number

Date Enlisted

Rank at Discharge

Date Discharged

Discharge on file at

Copy of Discharge

Yes

Name of Wars

Funeral Service Information

Place of Service

Name of Funeral Home

Address

Phone

Place of Visitation

I prefer the funeral service to be

Viewing of Family

Yes

Viewing of Friends

Yes

Religious Denomination

Place of Worship

Lodge/Union

Person(s) to Finalize Arragements at Time of Death

Full Name

Street Address

City

State

Zip

Phone

Special Instructions

Flower Preference

Music

Casket Bearers (6)

Jewelry

Glasses

Clothing

Other

Disposition Options

I prefer

Cemetery

Address

Phone

Section

I have made a last will and testament

Other Information and Special Instructions

Please list any other instructions or information you would like us to have

Memorials and Charities

Please list any Memorials or Donations to Charity that you would like

Contact Options

Send information about pre-arrangement

Contact me to set an appointment

Please keep my information on file

Personalized funeral and cremation services Burlingame, Funeral Director, estate planning, pre need funeral counselors

Meet Our Manager

John Crosby

For John Forest Crosby, serving families at Crosby- N. Gray Funeral Home truly runs in his genes... More

Many thanks for your splendid work on Bob’s memorial service. Mark was marvelous as well-please thank him from me.

— Ann M.

Thank you for being so understanding and handling everything in a very professional manner.

— George

Thank you for all your help during this tragedy. This has been a really sad holiday for me. Thank you and your staff for your kindness.

— Gay

Thank you so much for everything you did for our family. Your very thoughtful and caring attention to details to make our Mom’s passing both beautiful and comforting.

— Toni M., Cheryl M.

Thank you for all your work with the memorial service of my dad, James Case. It is greatly appreciated. Have a wonderful day.

— Steph J.

Need a Speaker for
your Organization?

Request Info

Crosby-N. Gray & Co. Funeral Home

650-342-6617

Main menu