Advance Planning Form

There are numerous benefits to pre-arranging a funeral, some of which include:

Please take a few minutes to fill out the Online Advance Planning form below. Once the information is submitted, a W.S. Clancy Memorial Funeral Home representative will review and be in touch.

If you'd prefer, a printer-friendly version of this form is also available for you to download. CLICK HERE to download.

NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence - we do not release any information to outside parties under any circumstances.

Information about the Person Completing this Form:

Vital Info about the Person for Whom Pre-arranging is Being Done:





Work:

Veteran:

Are you a veteran?:

Funeral Service Info:

Special Instructions:


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Disposition Options:

Other Information and Instructions:

Please list any other instruction or information you would like us to have:

Memorials & Charities:

Please list any memorials or donations to charity that you would like to declare:

Options:

Please select one of the options below: