Funeral Preplanning Form

Pre-Planning Checklist and Preferences for Your Funeral
or Memorial Service

Pre-planning your funeral or memorial service can provide peace of mind for you and lower anxiety for your
family and friends during an emotionally charged period. You can design and specify the exact type and
content of service that you would prefer. This will let your family and friends celebrate you and your life as you
would wish. Your family will not have to be conflicted or anxious about the complicated and emotional
decisions that will have to be made. This is meant to be of assistance in allowing you to make some of the
more relevant decisions to allow for the celebration of your life.

Name:                                                                            Date of Birth:                                                  
Address:                                                                ___                     Phone:                                         


  1. What type of Service and Events do You Wish to Have

 Decide on the type of Service


I would like to have a funeral service, followed by burial, interment or cremation. Funeral service to be held
______in the Church,
______at the grave site/interment facility or
______at the mortuary chapel.
Register Book              Yes               No

______I would like to have a memorial service at the church after the family only burial/interment or cremation

_______I would like to have a funeral service in my own home or facility

_______I would prefer to a         morning or           afternoon service

_______I would prefer a meal be prepared at the Church for        family or          family / friends

_______I would ask that my family be seated on the             right side                left side of the Sanctuary as looking into the Sanctuary.



  1. Decide if you wish any other funeral particulars;

______I would like to have a viewing before the funeral

______I would like to have a wake before the funeral/service

______I would like to have a visitation before the funeral/service

______I would like to have a reception or gathering in Fellowship Hall or elsewhere after my funeral or memorial service; location                                                                   

Instead of flowers, I wish Contributions to be made to                                                

The casket or urn would be present during the service: yes___ no  ____ 
The casket to be open prior to the service_____  yes _______ no; the casket will be closed after the service.

2. I would prefer my funeral be facilitated using the services of funeral home:                                                
                                                        , located in                                                              ,                    


  1. Identify Personal Touches You’d Prefer at the Service

 For the funeral or memorial service;

The person I would like to officiate my funeral or memorial service is___________________
If unable for any reason, my second choice is                      

_______I would like the following, if able and available, to serve as pallbearers:


  1.                                                                        Phone                                    

  2.                                                                        Phone                                    

  3.                                                                        Phone                                    

  4.                                                                        Phone                                    

  5.                                                                        Phone                                    

  6.                                                                        Phone                                    

_______I would like the following, if able, willing and available, to deliver a Time of Tribute:

  1.                                                                        Phone                                    _

  2.                                                                        Phone                                    _

  3.                                                                        Phone                                    _

______I would like the following, if able, willing and available, to tell true stories of my life:

  1.                                                                        Phone                                    _

  2.                                                                        Phone                                    _

  3.                                                                        Phone                                    _


  1. For the content of the funeral or memorial service:

________I would like the following music/hymn selections

________I would appreciate music presented by

  1. Instrumental                    

  2. Solo/Ensemble                

  3. Choir                               

  4. Organist                           

  5. None                                 

_______ I would like the following scripture texts presented;


  1. The Cemetery is                                                                , located                      miles from the Church.


  1. Military or Fraternal Order service at the grave/interment site:                  yes                      no


  1. Flag Presentation or Honor Guard at grave/interment site:                       yes                     no


  1. I would want to be sure that the following groups, organizations, service clubs will be notified

  2. of and invited to any service on my behalf.


  1.                                                                                     Phone                                             


  1.                                                                                     Phone                                             


  1.                                                                                     Phone                                             


  1. I would want the following people, whom my family may know, to be notified of and invited to any
    service on my behalf:

    1.                                                                                     Phone                                             


  1.                                                                                     Phone                                             


  1.                                                                                     Phone                                             


  1.                                                                                     Phone                                             


  1. I understand that in the State of Texas, an Advanced Directive Form (to communicate your wishes
    about medical treatment at some time in the future when you might be unable to make your wishes
    known) is required by law, along with the Medical Power of Attorney and, if so desired, the 
    Out of Hospital Do Not Resuscitate Order. These are the responsibility of the family of the 
    individual for whom this service is intended. The need for these documents is acknowledged 
    by my signature below:

Name of Person Requesting a Service                                 

  1. Prepared by:                                                                                                                                                                    Name                                                                                Date

 Witnessed by:                                                                                                                                                                                  Name                                                                            Date                 

  1. Acknowledged by First Presbyterian Church of Mabank on   

    Date                                  Signature









First Presbyterian Church Mabank
Funeral Planning Form









Printed Name                                                                                     
                                                                                                                                                (05/19/2019 approved by Session)

Welcome to First Presbyterian Church of Mabank, Texas