WALKER FUNERAL HOME
SYLVANIA | MAISON-DARDENNE-WALKER
MAUMEE | ROBINSON-WALKER
OAK HARBOR | ROBINSON-WALKER
GENOA | GERNER-WOLF-WALKER
PORT CLINTON

On-line Pre-planning Form

There are numerous benefits to pre-planning a funeral, some of which include:

Provides peace of mind
Relieves your loved ones of unnecessary concern
Reflects your expressed wishes
Alleviates financial burden on your family

Please take a few minutes to fill out the Online Pre-planning form below. Once the information is submitted, a Walker Family Funeral Homes representative will review and file it and will be in touch with you to further discuss the details of your arrangements.

If you'd prefer, a printer-friendly version of this form is also available for you to download and fill out manually. CLICK HERE for further instructions and the download link, if interested.

NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence - we do not release any information to outside parties under any circumstances.

Information About the Person Completing this Form:
* First Name:
* Last Name:
Middle Name:
* E-mail:
Street Address:
City:
County:
State:
Zip Code:
Phone:
Person for Whom I Am Pre-planning:

Vital Information About the Person for Whom Pre-planning Is Being Done:
Last Name:
First Name:
Middle Name:
Sex:
Marital Status:
Social Security #:
Date of Birth:	(ex. 1999)
Place of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Place of Marriage:
Date of Marriage:	(ex. 1999)
Father's Full Name:
Mother's Name:
Mother's Maiden Name:

Work and Education:
Education:
Usual Occupation (most of life):
Kind of Business:
Company:

Military Records:
Branch of Service:
Serial Number:
Date Enlisted:
Rank At Discharge:
Date Discharged:
Discharge On File At:
Copy of Discharge Papers:	Yes No
Name(s) of War(s)/Conflict(s) Toured:

Funeral Service Information:
Place of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer the Funeral Service To Be:
Viewing for Family:	Yes No
Viewing for Friends:	Yes No
Religious Denomination:
Place of Worship:
Lodge / Union:

Person(s) To Finalize Arrangements At Time of Death:
Check here and skip this section if the person filling out this online form is also the person making the final arrangements.

Full Name:
Street Address:
City:
County:
State:
Zip Code:
Phone:

Special Instructions:
Flower Preference:
Music
Casket Bearers (x6):
Jewelry:
Glasses:
Clothing:
Other:

Disposition Options:
I Prefer:
Cemetery:
Address:
Phone:
Section:
I Have Made A Last Will And Testament:	Yes No

Other Information & Instructions:
Please list any other instruction or information you would like us to have:

Memorials & Charities:
Please list any memorials or donations to charity that you would like to declare:

Options:

Please select one of the options below:

Send Information About Pre-planning

Contact Me To Set An Appointment

Please Keep My Information On File

* Please indicate which Walker Family Funeral Home you would like to work with in making your pre-planning arrangments:
(the information you are submitting on this form will be directed to the location you indicate)

Pre-planning Form - Printer-friendly Version:

You can download the printer-friendly version of the Pre-planning form to your local computer from the link below. Once downloaded, open the PDF *, and enter you information on the form, then print it out on your printer. You may then either mail or fax it to us at the address or fax number below, or bring it with you when you visit.

» CLICK HERE to download the form - choose to, 'Save to Disk,' in the dialog box that appears (download times will vary depending upon connection.)

* NOTE: Adobe Acrobat Reader software is required to view this file - if you don't already have the Reader installed on your computer, it is available for free from Adobe's website - please click the icon at right to be taken to the download page.

Mail completed forms to the respective address:

Walker Funeral Home
Sylvania Township
5155 W. Sylvania Ave.
Toledo, OH 43623

Maison-Dardenne-Walker Funeral Homes
501 Conant St.
Maumee, OH 43537

Robinson-Walker Funeral Home
165 East Water Street
Oak Harbor, OH 43449

Robinson-Walker Funeral Home
501 West Street
Genoa, OH 43430

Gerner-Wolf-Walker Funeral Home
216 Washington Street
Port Clinton, OH 43452

Please call with any questions: (419) 841-2422