For questions or immediate assistance, please call 856-452-5440. Please select a package below, payment is not due at time of submission.* Simple Cremation Package - $1995Includes online cremation arrangements, removal from place of death, minimum cremation container, crematory fee, photo identification of the deceased, sanitary care, basic plastic urn *Includes cremation arrangements. Memorial Service Package - $4500 Includes professional services of funeral director and staff, online cremation arrangements, removal from place of death, minimum cremation container, crematory fee, photo identification of the deceased, sanitary care, basic plastic urn, Use of facility for gathering and memorial service (Monday-Friday 9am to 5pm) *Includes cremation arrangements. Full Service Package - $6995 Includes professional services of funeral director and staff, online cremation arrangements, removal from place of death, minimum cremation container, crematory fee, photo identification of the deceased, sanitary care, basic plastic urn, Use of facility for gathering and funeral service (Monday-Friday 9am to 5pm), metal rental casket for the viewing, dressing, casket and cosmetics *Includes cremation arrangements. Additional Services $100 for additional removal staff – if a death occurs at home or a nursing facility and more than one removal personnel is required $295 in person private identification up to ½ hour for 5 people $550 Saturday surcharge $450 Weekday evening surcharge $25 initial death certificate, $5 permit, $2 each additional death certificate Contact PersonFields marked with an asterisk (*) are required.Name* First Middle Last Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Phone*Cell PhoneWork PhoneSocial Security Number The SSN is required to complete the arrangements. If you don't feel comfortable entering the information here, we will call you by telephone to retrieve the SSN.Beneficiary Person InformationName* First Middle Last Sex*MaleFemaleDate of Birth* MM slash DD slash YYYY Birthplace: City, State, Country* Social Security Number The SSN is required to complete the arrangements. If you don't feel comfortable entering the information here, we will call you by telephone to retrieve the SSN.Marital Status*MarriedNever MarriedWidowedDivorcedName of Spouse (maiden name, if wife) In Armed Forces*YesNoUsual Occupation* Kind of Business/Industry* Primary Education (select highest completed)*8th grade or less9-12th no diplomaHigh school graduate or GED completedHigher Education*NoneSome College CreditAssociates DegreeBachelors DegreeMasters DegreeDoctorateParentsLegal forms require this information. If you do not have this information, 'Unknown' will need to be inserted.Father's Name* First Middle Last Step-Father Name Mother's Name* First Middle Last Maiden Step Mother Name Family InformationIn each section below, please list first and last names, from oldest to youngest, including spouse names and noting "deceased if/where relevant.ChildrenGrandchildrenGreat GrandchildrenSiblingsMembership in Organizations, Clubs or SocietiesOrganizations, Clubs, Societies: Name & Contact InformationUse separate line for each entry.
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