Digital Arrangement Form
Step
1
of
7
14%
Name
*
First
Middle
Last
Obituary Photo
Max. file size: 2 GB.
Date of Birth
*
MM slash DD slash YYYY
Date of Death
*
MM slash DD slash YYYY
Age
Gender
*
Male
Female
Ethnicity
Please select »
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White / Caucasian
Place of Death
*
Marital Status
Please select »
Married
Separated
Widowed
Divorced
Never Married
Civil Union
Unknown
Married Date
MM slash DD slash YYYY
Place of Marriage
Survives
Yes
No
Spouse Name
First
Middle
Last (Maiden)
Military Branch
None
Army
Air Force
Coast Guard
Marine Corps
National Guard
Navy
Space Force
Residence Address
Father's Name
First
Middle
Last (Maiden)
Mother's Name
First
Middle
Last (Maiden)
Education
Please select »
8th Grade or Less
9th - 12th (no diploma)
Highschool Grad or GED
Some College
Associates
Bachelor's
Masters
Doctorate
Usual Occupation
Type of Industry
# of Death Certificates needed
Children's Names
Grandchildren's Names
Great Grandchildren's Names
Siblings
Other Family / Friends / Pets
Proceeded in death by
Hobbies / Interests
Memorial Donations
Write an Obituary
Note: Does not need to be a press-ready obituary. You can skip this step or use it to start gathering ideas
Your Name
*
First
Last
Phone Number
*
Email
Preferred Method of Communication
*
Please select »
Call
Text
Email
How did you hear about us?
*
Google / Bing
Facebook / Social Media
TV
Radio
Magazine
Billboard
Referral
Other
Phone
This field is for validation purposes and should be left unchanged.
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