Service Preferences
Choose the services that are right for you.
Veteran Service
I would like to have the United States flag that is provided for me by the United States Government Yes No
I would like Military Honors Yes No
Flag to be received by: ______________________________________Other: __________________________________________
Service Details
Religious denomination: _____________________________________ Church affiliation: _________________________________
If available, I would like:
Clergy or Celebrant: ____________________________________________________________________________________
Eulogy or words of remembrance: __________________________________________________________________________
Special songs or music: __________________________________________________________________________________
Scripture or special readings: ______________________________________________________________________________
Organist/Pianist/Bagpiper: ________________________________________________________________________________
Soloist/Vocalist(s): _____________________________________________________________________________________
Floral Preference
My favorite flowers are (type and color): _________________________________________________________________________
I prefer (Florist name): _______________________________________Phone: __________________________________________
In lieu of flowers, I prefer donations to be made to __________________________________________________________________
Cosmetology and Dressing Instructions
Clothing: _______________________________________________________________________________________________
Hairstyle: _______________________________________________________________________________________________
Cosmetic nails: ___________________________________________________________________________________________
Eye glasses: ______________________________________________________________________________________________
Accessories: _____________________________________________________________________________________________
Other: __________________________________________________________________________________________________
Pallbearers
I would like the following pallbearers (list names, minimum of 6 recommended)
1. _____________________________________________________ 5. _____________________________________________
2. _____________________________________________________ 6. ____________________________________________
3. _____________________________________________________ 7. _____________________________________________
4. _____________________________________________________ 8. ____________________________________________
Special Instructions/Notes
_______________________________________________________________________________________________________
_______________________________________________________________________________________________________
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for Spouse/Domestic Partner