Barnes Funeral Chapel
Making Prearrangements
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Prearranging your funeral just makes sense…

Making sound decisions in advance can relieve your loved ones of this responsibility during a time of stress. Often, families agonize over what you would have wanted. By selecting your options ahead of time, there is no doubt. Your choices can be adjusted as your wishes change. Knowing that your wishes are recorded can be very reassuring for you and your family.

Barnes Funeral Chapel will under no circumstances share your information with another company. For further concern, please read our privacy policy.

First Name:
Middle Name:
Last Name:
Maiden Name:
Nickname:
Address:
City:
State/Province:
Zip Code:
Country:
Phone:
Email Address:
Birth Date:
Birth Place:
Social Security #:
Marital Status:
Marriage Date:
Spouse's Name:
Spouse's Maiden Name:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Next of Kin:
Next of Kin Phone:
Education:
Job Title:
Employer Name:
Military Branch:
Service Number:
Rank:
Enlistment Date:
Discharge Date:
War Served:
Service Location:
If Other:
Service Type:
If Other:
If Military Service:
Service Leader(s):
Memorial Contributions:
Clothing Requests:
Music Requests:
Flower Requests:
Special Requests:
Disposition:
If Burial, Cemetery:
If Cremation, Disposition of Ashes:
Contact Requests:Contact me to set an appointment
Please keep my information on file
  

Barnes Funeral Chapel
5825 State Highway 109
Delta, OH 43515

Phone Number: (419) 822-5995

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