Online Planning Form | Northern Virginia Burial & Cremation Society

Information about the person completing this form

I am planning for*

Name*

Prefix First Last Suffix

Middle

Phone*

Email*

Address

Street Address Address Line 2 City State ZIP Code

Hidden

County

Are you currently a member of Northern Virginia Cremation Society?*

Yes
No

Would you like to learn more about prepayment options?*

Yes
No

Show Detailed Form?*

Yes
No

Information about the person you are planning for

Name*

Prefix First Last

Middle

Gender

County the person you are preplanning for lives in?*

Marital Status*

Last name at birth:*

Date of Birth*

Place of Birth*

Spouse's Full Name*

Spouse's Maiden Name*

Mother's Full Name*

Mother's Maiden Name*

Father's Name*

Work and Education

Education (Primary)

Years Attended

College (1-5+)

Years Attended

Usual Occupation (most of life)

Kind of Business

Military Records

Branch of Service

Person(s) to Finalize Arrangements at Time of Death

Full Name

Street Address

City

State

Zip

Phone

Email*

Phone

This field is for validation purposes and should be left unchanged.