Pre Planning Funerals : Dodge-Thomas Funeral Home : Glen Cove, NY - Glen Head, NY - Locust Valley, NY - Oyster Bay, NY

Pre-Planning

Pre-Plan a Funeral with Dodge-Thomas. Our family run business has helped families and individuals Pre-Plan Funerals since 1816. Below is a short form to help you and the Directors at Dodge-Thomas get an idea of what you are looking for in regards to Funeral Arrangements. All of the information you enter is stored in our safe, secure and confidential contact system. Please remember the information you enter is optional; so if you don't feel comfortable entering it online please Contact Us directly, or enter as much information as possible.

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:

For security, please enter the letter or number displayed in the corresponding box below each character. The letters do not have to be capitalized

Dodge-Thomas Funeral Home - Glen Cove
26 Franklin Avenue
Glen Cove, NY 11542
(516) 676-1180