General Pre-Arrangements Form (Complete and press "Submit" for us to receive it) | Giles & Yeckley Funeral Home and Crematorium, Inc. | Cremation, Mohnton PA, Reading, PA, Berks County, PA, funeral home and cremation

Full Name of the Person these arrangements are for. Now referred to as the "Client"

Street

City

State/Province

ZIP/Postcode

Client's Date of Birth

Client's SSN #

Client's Place of Birth (City & State)

Client's Father's First & Last Name

Client's Mother's First & Maiden Name

Client's Marital Status

If Married, Client's Spouse's Name

Client's Spouse's Maiden Name (if female)

Client's Occupation (Job Title for majority of working career)

Did Client serve in the military?

YesNo

Person in charge of final arrangements (Family Member)

Street Address (City, State, Zip Code)

Telephone

Select the Client's Service Preference

Direct Cremation No Services

Cremation First followed by a Memorial Service

Cremation First followed by a Graveside Service

Viewing in Open Casket then Cremation

Viewing Funeral Service then Burial in Casket

Graveside Service then Burial in Casket

Direct Burial in Casket no Service

Other Not listed above

Additional instructions for us

Please select from one of the options below:

Contact me to set up an appointment to pre-pay for these services.

No appointment needed just keep my request and information on file.

I have additional questions, please call me.