Direct Mail Survey

Full Name *

Email

Phone *

When is the best time to call?

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Address

Street Address *

City *

State *

Postal code *

How old are you? *

under 25

25-40

41-65

66 or older

Are you currently:

Employed

Retired

Have you ever been responsible for making funeral arrangements? *

Yes

No

Which of the following would you choose for yourself? *

Burial

Cremation

How much might you expect to pay for a funeral? *

Under $5,000

$5,000 - $6,000

$7,000 - $8,000

Over $8,000

Do you own cemetery property? *

Yes

No

If your arrangements have not been made in advance, who would be responsible to make those decisions for you?

Wife/Husband

Kids

Family member

Other

If your loved ones needed to make choices for you, would they know what you’d want?

Yes

No

Are you aware that payment plan options are available for prepaid funeral arrangements?

Yes

No

funeral home location

Thank you for completing the survey!

We’d like to share the free REMEMBER booklet with you. This is a 23-page, fill-in-the-blank guide that makes it easy to reflect and record your personal wishes. One of our representatives will contact you shortly or feel free to schedule your own appointment with the calendar link on the next page.

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