Enter your selections in the following fields and we will create a record for your family.
*Fields are required
*City, State, & Zip Code:
Mother's Name (Including Maiden Name):
Spouse's Name (Maiden Name, If Wife):
Date & Place of Marriage:
Preference of Disposition:
Church Membership or Religious Affiliation:
Other Memberships, Organizations, Volunteer Work, etc.:
Survivors (Spouse) and City of Residence (Children, Siblings, Number of Grandchildren):
Cemetery Name and Location:
Memorial Contributions Should Be Directed To:
Music (Song Selection and CD or Organist and/or Vocalist):
Jewelry or Items Desired To Be In Casket or Cremation Container:
Vault or Urn Selected: (Click on Links for Options)
If we have any questions, regarding your information, we will notify you promptly.
Copyright © 2005 - 2015 Clary Funeral Consultants, Inc.
3004 West Lake Avenue
Peoria, Illinois 61615