Basic Information Form

This form consists of 4 parts. It includes most of the information needed to make funeral arrangements for yourself or another. Much of the information is required for legal documents, such as the death certificate.  Other information helps you decide what type of funeral you would like.

You may print this form blank, or after you have filled all or part of it in. You may also submit the form online using the instructions at the end.

By law, cremation requires the signatures of all closest next of kin. The Cremation Authorization Form is available here.

Note: Memorial Alternatives will place an obituary in the Grand Rapids Press. All other newspaper obituaries should be handled directly by the family.
 

PART A     INFORMATION ABOUT THE DECEDENT

Name (first, middle, last)

Gender

Date of Birth (month/day/year)

Usual Occupation (give kind of work done during most of working life)

Kind of Business or Industry

Current Residence Address

Locality

City

 If other:

County

State

Zip Code

Mailing Address (if different from above)

Birthplace (City and State or Foreign Country)

Marital Status

Surviving Spouse (if wife, give name before first married)

Was decedent ever in US Armed Forces?

Hispanic Origin

Ancestry (Mexican, Puerto Rican, Cuban, Central or South American, Chicano, other Hispanic, Afro-American, Arab, English, French, Finnish, etc.)

Race (American Indian, Black, White, etc. If Asian, give nationality i.e., Chinese, Filipino, Asian Indian, etc.

Decedents Education
(Specify highest grade completed)

Father's Name (first, middle last)

Mother's Name
(first, middle, surname before first married)

 

PART B     FUNERAL SERVICE   -GENERAL QUESTIONS

If a funeral or memorial service is selected, where is it to be held?

What Clegy is to Officiate?

If Burial, what cemetery?

 Other

If Cremation is selected, what should be done with the cremains?

Family to pick up.
Mailed to ($30 CONUS mailing fee applies):

Deliver to Local Cemetery (no charge for local cemetery delivery):

Other (inicate):

Please List at least 2 Survivors (name, relationship, address, phone number)

Person to finalize arrangements at time of death (name, relationship, address, phone number)

Number of Death Certificates needed to settle legal affairs (Kent County charges $10 for the first and $3 for each additional)

PART C     FUNERAL SERVICE  -SPECIFIC QUESTIONS

I am interested in:
(To review merchandise in a new window, click Burial Packages or Cremation Packages)

Burial
Packages:
Cremation
Packages:
   Urn and/or urn vault selected  

Packages may be upgraded. If desired, indicate the casket and/or vault you would like:

I donīt want a package, I want:

PART D    FINAL FORM INFORMATION

If cremation is selected, all of the closest next of kin need to fill out the Cremation Authorization Form. This form can be viewed and/or downloaded here.

If someone other than the person the funeral arrangements are for is completing this form, provide name, address, relationship, phone #, email address:

Please call me to finalize the arrangements. My phone number is

Please just keep this information on file for now.

Email address (we will confirm receipt of this form):

For information on prepaying for your funeral services, see our pre-arrange page.

If you prefer to sit down and talk with a counselor, please email or call for an appointment. Our phone number is (616) 363-3700. We are in the office Mondays through Fridays, 9am  to 4:30pm.

Click “Submit” below to send this form to us. You may care to scroll up and review your input at this time. You can edit any entry individually. To print the form with your entries, click your browser's print button.

 

 

 

FAQS, FORMS & DOCUMENTS

Cremation Authorization Form
Basic Information Form

Funeral FAQs
Arranging for Burial
Arranging for Cremation
FAQs About Cremains
Options for Veterans

The advantages of making arrangements in advance make good sense.
How and Why to Pre-Plan
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Memorial Alternatives - A Grand Rapids, Michigan Funeral Home Providing Low Cost Cremation and Burial Services.