717.664.2270

info@spencefuneralservices.com

Make At-Need Arrangements Online

Make At Need Arrangements Online

Step 1 of 1

This tool should only be used once you have contacted the funeral home and have informed them of your immediate needs. This form can be used as an easy way to get all your wishes and information in one place, from the comfort of your own home.

Your Information

Full Name*:

Relationship to Deceased*:

Mailing Information

Address*:

City*:

Country*:

State/Province*:

Zip/Postal code*:

Email Address*:

Phone Number*:

Enter your 10-digit phone number.

Alternate Phone:

Deceased's Information

Full Name*:

Mailing Information

Address*:

City*:

Country*:

State/Province*:

Zip/Postal code*:

Date of Birth:

Please enter the date MM/DD/YYYY.

City/Township/Borough of Birth:

State of Birth:

Social Security Number (Optional):

State of Death:

Deceased's Spouse Information

Marital Status*:

Marriage Date:

Spouse's Name:

Spouse's Maiden Name:

Spouse's Address

Address:

City:

Country:

State/Province:

Zip/Postal code:

Deceased's Father & Mother Information

Deceased's Work & Education

Education:

Occupation:

Kind of Business:

Company Name:

Years of Employment:

Deceased's Military Information

Was the Deceased a Veteran?*:

Yes

Branch Service:

Please provide a copy of DD214 or equivalent to the funeral director.

Deceased's Funeral Service Information

Place of Service:

Prefered Funeral Service to be Public Or Private:

Viewing for Family:

Yes

Viewing for Friends:

Yes

Religious Denomination:

Place or Worship:

Lodge or Union:

Deceased's Disposition Information

Deceased's Preference:

Final Resting Place:

Please provide cemetery deed to funeral director, if available.

Additional Information

Flower Preference:

Music Selections:

Casket Pallbearers:

Jewelry:

Glasses:

Clothing:

Special Instructions

Email*:

Name*:

Message*:

Admin Login

717.664.2270

info@spencefuneralservices.com

Make At-Need Arrangements Online