Dahsner-Straus Funeral Homes
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One of the services we offer to help families in our community is our advance funeral planning program. Using one of our preplanning services relieves your family of the burden of making funeral arrangements and at the same time allows your funeral wishes to be honored.

We will be happy to share with you the advantages and costs of funeral planning.

For more information about preplanning call us today or stop by. If you would like to begin saving your information you can simply fill out the form below and we will contact you in a timely matter. There is absolutely no obligation. Our informative consultation is free.

Your Full Name:

Your Email Address:

Your Maiden Name:

Street/Mailing Address:



Date of Birth:

Place of Birth:

Social Security Number:

Spouse's Name:

Spouse Survived?
Yes     No

Marital Status:

Date of Marriage:

Place of Marriage:

Names of Previous Spouses:

Names of Parents:

Address of Parents (if still living):

Names of Children:

Addresses and Phone numbers of Children:

Names of Brothers and Sisters:

Addresses and Phone numbers of Brothers and Sisters:

Names of other friends and relatives who should be notified:

Addresses and Phone numbers of other friends and relatives:


Names of present and previous employers:

Addresses and Phone numbers of present and previous employers:

If you are a veteran
Date of enlistment:

Place of enlistment:

Date of discharge:

Place of discharge:


Service Numbers:

Organization or outfit:

Commendations received:

Location of discharge papers:

Flag desired to drape casket:

Religious affiliation:

Professional and fraternal organization memberships:

Education (list schools attended and dates of any degrees or honors received):

Names of newspapers for obituary:

Organ Donation (list of authorized card and anyone who should be notified):

Funeral director or funeral home you prefer:

Clergyperson or anyone else you would like to officiate:

Funeral Service Location:

Visitation instructions:

Music, hymns or readings you would prefer during your service:

Memorial Donations you would like in your memory:

Names and Addresses and Phone Numbers of casket bearers:

Cemetery Name:

Address and location of cemetery property (include lot and grave number):

Casket and/or vault preference:

If you wish to be cremated, include disposition preference:

Location of will:

The name of the executor of your estate:

Address and phone number of the executor of your estate:

Location of safety deposit box and key:

Attorney's name:

Attorney's address and phone number:

Location of checking accounts, checkbooks, savings accounts and passbooks:

Credit cards and charge accounts to be canceled.
(For security purposes do not list Credit Card Numbers here, just the names of cards.)

Insurance company name and policy numbers:

Location of insurance policies:

Any additional instructions:


Dashner Funeral Home • Dupo, Illinois
Strauss Funeral Home • Millstadt, Illinois


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