NEWTOWN MONTHLY MEETING OF FRIENDS
NEWTOWN, PA 18940

Please consider completing this form and giving it to your next of kin. If desired, a copy of this form may also be kept at Newtown Meeting though we are unable to assure that it will be kept in a totally secure file.

Information about what you would like the Meeting to do in the event of your death.

Full name _____________________________________________ Date ________

Full name spouse/partner_______________________________________________

Full name of father ___________________________________________________________________

Full name of mother ___________________________________________________________________

Full name(s) of children, if applicable ___________________________________________

Do you wish to have a funeral or memorial service? At Newtown Meeting or elsewhere? Jf elsewhere, please let us know where._______________________________________________

Are there any special instructions for flowers, music, readings, etc. Do you want an open or closed casket, or cremation? _____________________________________________________

Is there a letter of instructions or other document dealing with these questions? May we have a copy which we will keep confidential (sealed until date of death if you wish). ____________________________________________________________________________

Is there anybody in particular you would like to assist with a service? ____________________________________________________________________________

If we are the first to learn of your death, whom should we contact? _______________________

Do you have a graveyard plot at Newtown Meeting? _______If elsewhere, where? _____________________________________________________________________________

______________________________________________________(It is advisable to do this for all family members in advance of need.)

Name and address of lawyer _____________________________________________________________________________

Where is signed and properly executed will located?___________________________________

Please list any information that might be helpful in the preparation of a memorial minute on the reverse side of this form.

If people want to make memorial gifts in your memory to whom or what group should such gifts be made? ____________________________________________________________________