ABOUT US
OBITUARIES
SERVICES
PLAN AHEAD
GRIEF SUPPORT
RESOURCES

ABOUT US
OBITUARIES
SERVICES
PLAN AHEAD
GRIEF SUPPORT
RESOURCES

ONLINE PLANNING FORM

Secure Online Planning Form

If you have any questions, or would like assistance with this form, please call 724-929-6183 or 724-736-2515.

Online Preplanning Form

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Personal Information

Who is this plan for?

First Name

Middle Name

Last Name

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About You

Email Address

Phone Number

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Family, Work, & Education

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Family Information

Father's Name

Mother's Name

Mother's Maiden Name

Marital Status

Spouse's Name

Spouse's Maiden Name

Place of Marriage

Date of Marriage

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Additional Family Members

Siblings (alive)

Siblings (deceased)

Children (alive)

Children (deceased)

Grandchildren (alive)

Grandchildren (deceased)

Great-Grandchildren (alive)

Great-Grandchildren (deceased)

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Education History

School Name

Highest Level of Education

School Location

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Work History

Occupation

Company Name

Years At Company

Did this person serve in the military?

Yes

No

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Your Wishes

Visitation Options

Visitation at funeral home

Visitation elsewhere:

No Visitation

Funeral Service Option

Funeral service at funeral home

Funeral service elsewhere

No Visitation

Reception Options

Reception at funeral home

Reception elsewhere:

No Visitation

Would you prefer burial or cremation?

Burial

Cremation

Final Disposition

Ground Interment (burial)

Mausoleum Entombment (above ground burial)

Columbarium (for cremation urns)

Ashes returned to family

Would you prefer to include a graveside/committal service?

Yes

No

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Your Preferences

Please list any musical selections you would like to include in your services.

Please list any special themes you would like to include in your services.

Please list any poems, religious texts, or readings you would like to be read at your services.

Please list any specific foods or beverages you would like to make available to your family and guests at the services.

Please list any interests or hobbies you would like to include into your services.

Is there a special story, personal thank you, or message of hope you would like to be read during your services?

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Belle Vernon

Michael J. Parzynski, Director/Owner

Leonard J. Parzynski, Director

Rachael L. Parzynski-Weaver, Funeral Director

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Belle Vernon

Michael J. Parzynski, Director/Owner

Leonard J. Parzynski, Director

Rachael Parzynski Weaver, Funeral Director

Perryopolis

Michael J. Parzynski, Director/Owner

Leonard J. Parzynski, Supervisor

Rachael L. Parzynski-Weaver, Funeral Director

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