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Preplan Online

Pre-Plan Online

Please fill out the information below and press "SUBMIT" to forward it to our funeral home.


Personal Info

YOUR PERSONAL INFORMATION:

 

BENEFICIARY'S PERSONAL INFORMATION:

 
 
 
Family Info
 
 
 
 
 
Education/Work
 
 
Military Service
 
 
Service Options

VISITATION OPTIONS:

 

FUNERAL OPTIONS:

 

RECEPTION OPTIONS:

 
 
Service Requests

Please list any musical selections you would like to include in your services.

Please list any poems, religious texts, or readings you would like to be read at your services.

Please list any interests or hobbies you would like to include into your services.

Please list any special themes you would like to include into your services.

Please list any specific foods or beverages you would like to make available to your family and guests at the services.

Is there a special story, personal thank you, or message of hope you would like to be read during your services?

 
 
Final Disposition

 

 

DISPOSITION OPTIONS:

 


Thank you for taking the time to complete this form. A member of our staff will review your information and contact you to further discuss the details of your arrangements.

 

Kurtz Memorial Chapel | (815) 806-2225
65 Old Frankfort Way P.O. Box 1031
Frankfort, IL 60423

Kurtz Memorial Chapel | (815) 485-3700
102 E. Francis Rd. P.O. Box 129
New Lenox, IL 60451

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