Becoming a member is free and easy. Just fill out our online form below and your instructions for carrying out your wishes are then entered in our local database.

Personal Information
Name
(First MI Last):
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: E-mail:
Spouse's Name: Spouse's Maiden Name:
Place of
Marriage:
Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:

Military Service
Service Branch: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Name Of Wars:

Final Disposition
Preference for
final disposition is:
Ground interment with
Mausoleum entombment
Cremation with
Cemetery Name:
Address:
A is owned at the above location

Person To Finalize Arrangements At Time Of Death
Name:
Relationship:
Address:
City: State: Zip:
Phone: E-mail:

Veterans Cremation Burial Society
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