Your Name *

First Name

Last Name

Phone (best contact number) *

Country code for the US is: 1

Country

(###)

###

####

Your Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Will you be providing a personal Photo for the Obituary? *

Photos must be uploaded or emailed in 200 dpi JPG format or actual photo delivered to AM Cremation & Funeral Care to be scanned. If no photo will be provided, a placeholder image of your choice will be displayed. Please ask us to view available images.

Yes

No

Where would you like the obituary posted? *

We will post an obituary on our Website for any decedent that we care for at no charge. If you would also like the obituary placed in any Newspaper(s) there may be an additional charge from us (if the package selected does not include obituary composition & placement assistance) plus the fee from the Newspaper directly.

On Our Website Only (no charge)

With a Newspaper Only (additional charges may apply)

On Our Website & with a Newspaper (additional charges may apply)

Deceased Date of Birth *

MM

DD

YYYY

Gender

Male

Female

Deceased Date of Death

MM

DD

YYYY

Date of Marriage to above Spouse

MM

DD

YYYY

Service Type

Please check any that are applicable

Private Services

Funeral Services

Memorial Services

Graveside Services

Direct Burial, No Services

Direct Cremation, No Services

Disposition Type

Please check any that are applicable

Burial

Interment

Entombment

Inurnment (burial of cremated remains)

Acknowledgement *

By Checking Here, I have verified that all names are spelled correctly and all information is accurate to the best of my knowledge.

By Checking Here, I understand that I will need to proof the final obituary and approve it prior to publishing online or submitting to a newspaper.