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Victory Funeral Services

Providing heartfelt services with dignity

Funeral Pre-Planning Form

This Funeral Pre-Planner Form allows you to submit your information directly to Victory Funeral Services to be held in our files until your time of need. Sharing this information with the person that will be the responsible party at the time of your demise would be beneficial. Make sure they have your social security number as well if you choose not to leave it here.

Sex:
Marital Status:
Inside City Limits?:
Education (check box that best describes highest degree or level of school)
Race:
Ever a peace officer in Texas?:
Ever in the U. S. Armed Forces?:
Name of organization in which service was rendered:
Medal of Honor Recipient:
Veterans Cemetery Marker:
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Thank you! Your information has been submitted successfully. You've made a very important decision. We will be in contact with you shortly.

Continue to the next page of this form to finalize your wishes.

Victory Funeral Services, 1004 Martin Luther King Drive, Kilgore, TX 75662 - 903-988-1122 phone 903-234-0511 fax -- [email protected]