Obituaries
Services
Who We Are

Plan Ahead
- Why Plan Ahead
- Pre-Plan Today
Resources
Contact Us

(301) 662-5520

Home
Obituaries
Services
Who We Are
Plan Ahead
- Why Plan Ahead
- Pre-Plan Today
Resources
Contact Us

Pre-Plan Today

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Pre-planning with us

Your Information

Your Information

Your First Name

Your Last Name

Email:

Phone:

Information about the person we are planning for

Information about the person we are planning for

Who's this plan for?

Case Name

Case Last Name

Gender

Male

Female

Other

Birth Date

Birth Place

Address - If Living

Family Information

Family Information

For the person we are planning for

Marital Status:

Married

Single

Widowed

Father's Full Name

Mother's Full Name

Siblings (Living)

Siblings (Deceased)

Children (Living)

Children (Deceased)

Grandchildren (Living)

Grandchildren (Deceased)

Great-Grandchildren (Living)

Great-Grandchildren (Deceased)

Education & Work

Education & Work

Highest Level of Education

School Name

School Location

Occupation

Years at Company

Military Service?

Yes

No

Branch of Service

Years Served

Interested in Honors?

Yes

No

Funeral Ceremony Options Title

Service Details

Funeral Ceremony

Visitation Options

Reception Options

Would you prefer a burial or a cremation?

Would you prefer to include a memorial service?

Yes

No

Have cemetery arrangements been made?

Ceremony Requests

Ceremony Requests

musical selections you would like to include in your ceremony.

poems, religious texts, or readings you would like to be read at your ceremony.

Interests or hobbies you would like to include at your ceremony.

Special themes you would like to include in your ceremony.

Specific foods or beverages you would like to be made available at your ceremony.

Is there a special story, personal thank you, or message of hope you would like to be read during your ceremony.

Thank you for contacting us.
We will get back to you as soon as possible.

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330 Catoctin Ave, Frederick, MD 21701

(301) 355-0723

office@rollinslifecenter.com

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Rollins Life Celebration Center | All Rights Reserved.