DENGEL & SON MORTUARY
Pre-arrangement On-line
Name(First MI Last):
Gender: Martial status:
Date of Birth: Place Of Birth:
Address:
City: State:
County: Zip:
Phone: Email:
Spouse's Name:
Spouse's Maiden Name:
Place of Marriage: Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:
Immediate Family Survivors: Relationship,Names and City and State:
Work/Education History
Education Level:
Degrees earned: Business: Industry:
Company: Number Of Years:
Additional Education / Employment Information
Military Service
Service Branch: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge on File at:
Name Of Wars:
Additional Military Service
Funeral Preferences
I Prefer My Funeral Service To Be:
Place Of Service:
Conclude Service At:
Religious Denomination:
Place Of Worship:
Clergy:
Type Of Clothing:
Type of preferred Casket:
Vehicle For Family:
Memorialization Instructions
Musical Selections To Be Played:
Musical Selections To Be Sung:
Favorite Bible Passages:
Favorite Literature Or Poems:
Favorite Flower(s):
Favorite Flower Color:
Final Disposition
Preference for final disposition is:
Cemetery Name:
A cemetery plot is owned at the above location? yes no
Special Instructions
Home | History | Facilities | Services Provided Advanced Planning | Obituaries | Caskets | Vaults Grief Support | Monuments | Local Services | Staff
Dengel & Son Mortuary dengelmortuary@sbcglobal.net
235 S. Hickory Street Ottawa, KS 66067 Telephone:(785) 242-2323
