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Home
Obituaries
About Us
Location
Services
Merchandise
Pre-Plan
Veterans
Resources

On-line Pre-arrangement Form

Please fill in the On-line Pre-arrangement Form and one of our representatives will contact you shortly.

There are numerous benefits to pre-arranging a funeral, some of which include:

Provides peace of mind
Relieves your loved ones of unnecessary concern
Reflects your expressed wishes
Alleviates financial burden on your family

Please take a few minutes to fill out the Online Pre-arrangement form below. Once the information is submitted, a Spear Miller Funeral Home representative will review and file it and will be in touch with you to further discuss the details of your arrangements.

If you’d prefer, a printer-friendly version of this form is also available for you to download and fill out manually. CLICK HERE for further instructions and the download link, if interested.

NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence – we do not release any information to outside parties under any circumstances.

Form name - click to set options

Information about the Person Completing this Form:

Email Address:*

Name:*First, Middle, Last

Address:

Street

City

State/Province

ZIP/Postcode

Telephone

Person for Whom I Am Pre-arranging:

Vital Information about the Person for Whom Pre-arranging Is Being Done:

Name:First, Middle, Last

Sex:

Marital Status:

Social Security #:

Date of Birth:

Place of Birth:

Spouse’s Full Name:

Spouse’s Maiden Name:

Place of Marriage:

Date of Marriage:

Father’s Full Name:

Mother’s Name:

Mother’s Maiden Name:

Work and Education:

Education:

Usual Occupation (most of life):

Kind of Business:

Company:

Military Records:

Branch of Service:

Military Serial Number:

Date Enlisted:

Rank At Discharge:

Date Discharged:

Discharge On File At:

Copy of Discharge Papers:

YesNo

Name(s) of War(s)/Conflict(s) Toured:

Funeral Service Information:

Place of Service:

Name of Funeral Home:

Address:

Number:

Phone:

Place of Visitation:

I Prefer the Funeral Service To Be:

Viewing for Family:

YesNo

Viewing for Friends:

YesNo

Religious Denomination:

Place of Worship:

Lodge / Union:

Person(s) to Finalize Arrangements at Time of Death:

Check here

Check here and skip this section if the person filling out this online form is also the person making the final arrangements.‎

Full Name:First, Last

Address:

Street

City

State/Province

ZIP/Postcode

Phone:

Special Instructions:

Flower Preference:

Music:

Casket Bearers (x6):

Jewelry:

Glasses:

Clothing:

Other:

Disposition Options:

I Prefer:

Cemetery:

Address:

Telephone

Section:

I Have Made A Last Will And Testament:

YesNo

Other Information & Instructions:

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

Memorials & Charities:

Please list any memorials or donations to charity that you would like to declare:

Options

Please select one of the options below:

Send Information About Pre-arrangement

Contact Me To Set An Appointment

Please Keep My Information On File

Pre-arrangement Form – Printer-friendly Version:

You can download the printer-friendly version of the Pre-arrangement form to your local computer from the link below. Once downloaded, open the PDF *, and enter your information on the form, then print it out on your printer. You may then either mail or fax it to us at the address or fax number below, or bring it with you when you visit.

CLICK HERE to download the form – choose to, ‘Save to Disk,’ in the dialog box that appears (download times will vary depending upon connection.)

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We stand ready to assist you. If a death has occurred, please call us on the number below:

1-203-259-0824

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