Mercer Funeral Home, Bluefield, WV

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MAKING THE DECISION TOGETHER

Planning your own funeral. . .

Makes your wishes known.
Means that your family can be involved in making these difficult decisions.
Relieves your loved ones of the financial responsibility.

Assisting our families with their funeral arrangements in advance is a service that we are proud to be able to provide. We offer pre-paid funeral plans, funded by bank trust and savings accounts, or by life insurance products which when fully funded gives the assurance of a plan that will keep up with inflation therby assuring your loved ones that your funeral plan is guaranteed. We offer flexible payment plans for those who wish to fund an account over a longer period of time and also offer the service of recording funeral information and wishes for those who elect not to fund their arrangements at this time but know what type of services they would want.

PRE-ARRANGEMENT FORM

This form is provided as a service to allow you to record vital information and funeral preferences for your loved one. Once you have filled in the information you may:

Click the submit button at the end of the form.
Print the completed form and place it with your important papers.

Please Select:
First Name:
Last Name:
Mailing Address:
Street:
City:
State:
Zip Code:
Email Address:
Birth Place:
Birth Date:
Phone:
Occupation:

Marital Status:
Date Married:
Place Married:
Spouse:
Mothers Maden Name:
Father:
Religious Affil:
Education:
Relative To Notify:	Their Phone:
Military Service:	Branch:
Rank:	Fraternal Org:

Service Information:
Clergy:
Service Place:
Memorials:
Other Information:
Music Selection:
Music 1:	Music 2:
Music 3:	Music 4:
Casket Bearers:
Casket Bearer 1:	Casket Bearer 2:
Casket Bearer 3:	Casket Bearer 4:
Casket Bearer 5:	Casket Bearer 6:

Mercer Funeral Home
& Crematory
1231 West Cumberland Road
Gerald R. Boyce, II Owner/Director
Bluefield, West Virginia, 24701
(Ph) 304-327-6155 (Fax) 304-325-3650
E-Mail Us

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