Your Vital Information

The information provided below will assit the funeral director in completing forms at the time of your death. By completing this information in advance it can provide your friends and family piece of mind that your obituary and information provided is exactly how you wanted. Once you have completed this form if there are any changes you do not have to redo the whole form, you may update the sections that have changed, or call (410) 939-2882 and speak with a staff member who will be happy to assist you.

Name
Maiden Name
Address (Street, City, State, Zip)
Phone Number (with area code)
Email
Marital Status	Single Married Divorced Widow Never Married
Date of Birth (mm/dd/yyyy)
Place of Birth (City, State)
Father's Name
Is your father still living?	YesNo
If Living (City, State)
Mother's Name (Maiden)
Is your Mother still living?	YesNo
If living (City, State)
Occupation
Education Level	Elementary SchoolMiddle School (Junior High)CollegeHigh School
Military Service	NoneArmyNavyAir ForceOther (please specify)Marine
Other (Military Service)
Service Number
Wars fought in
Military Honors	YesNo * If Honors are requested a DD-214 is required
Informant (Contact upon your death)
Informant Relationship
Informant Address
Informant Phone
Sons (Name City, State)
Daughters (Name City, State)
GrandChildren (Name City, State)
Brothers (Name City, State)
Sisters (Name City, State)
Other Family Members (Name City, State)
Memberships, Hobbies, and Clubs
Religion
Church Attended
Method You would like to be contacted?	TelephoneEmailMail