Welcome to Grant-Johnson Funeral Home

"The Option that Relieves the Burden from Your Family"

One of the most loving, caring things that an individual can do is to leave behind details and information in regards to Pre-Planning. If you feel it is too hard to discuss funeral arrangements at this time, just think how difficult it would be for your loved ones at a time of loss.

Advantages of Planning Your Funeral Arrangements

Pre-Planning will express your wishes.
Pre-Planning relieves your family from making difficult decisions at a time of loss.
Pre-Planning will give you and your family the security and satisfaction of knowing that all the arrangements have been planned and paid for.
Pre-Planning discounts for complete funeral packages save you money.

If you are ready to begin the Pre-Planning process, please call
Grant Johnson Funeral Home at 1-815-699-7711, or complete the form below.

Pre-Need Form

Personal Information
Name (First MI Last):
Marital Status:
Birth Date:		Birth Place:
Current Address:
City:		State:
Zip:		County:
Phone:
E-mail:
Spouse's Name:
Spouse's Maiden Name:
Marriage Date:		Marriage Place:
Father's Name:
Mother's Name:
Mother's Maiden Name:
Person in Charge:
Address:
Phone:
Work/Education History
Education (0-12):		College 1-5+:
Occupation:
Business:		Company:
Military Record
Branch of Service:
Serial Number:
Date Enlisted:		Discharge Date:
Rank At Discharge:
Discharge On File At:
Copy of Discharge Papers:		Yes
Name Of Wars:
Funeral Service Request
Place Of Service:
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Newspaper Information (Please list family members)
Children:
Brothers/Sisters:
Number of Grandchildren:
Other significant relatives:
Special Instructions
Lodges and Organizations:
Jewelry:
Glasses:
Lodge / Union:
Clothing Preference:		My own Other
Disposition Request
I Prefer:
Cemetery:
Address:
Phone:
Section:
Last will and testament exists:		Yes
Location:

Other Instructions
Memorials/Donations To Charity
Please select all that apply: Send information about pre-arrangement Contact me to set an appointment Please keep my information on file