Obituary – Full Step 1 of 16 - PAYMENT DETAILS 6% Please Enter Your Order #*Your Order number is found on the order confirmation email.Thank you! Press the continue button to begin the obituary form.Payment Confirmed Press the continue button to begin the obituary form. IMPORTANT: It typically takes 30-60 minutes to complete the obituary form. It is is highly recommended that you gather all of the information and details prior to filling in the obituary form.You WILL NOT have the option to save the form and come back to it later. However, you can always come back to the form and start from the begining.It is recommended that you look over the list of information that the form will ask about. You can view this list by CLICKING HEREUpon purchasing this service, you have agreed to the following: TERMS and CONDITIONS 1. TermsBy filling out and submitting the requested information on this form, you are granting M Memorial Services the rights to create an obituary using the information submitted on this form. By selecting YES below, you are acknowledging the following: Any fees paid, only applies to the writing of the obituary. Submission to a newspaper or any other publishing outlet is not included in the purchase price. Any information submitted can and will be used in the obituary. Most requested information is optional. There is no obligation to submit information that would be inappropriate for this obituary. Submitted information that is overly personal, defamatory, provocative or otherwise deemed inappropriate will not be used in the obituary. 2. Copyrights M Memorial Services claims no copyrights to the written obituary. The recipient of the completed obituary will hold all rights to the obituary, and is free to edit, copy, distribute in any way they see fit. M Memorial Services will retain a full copy of the original obituary as it was written. M Memorial Services will also retain all inputs to this form along with contact information for the individual requesting the obituary. M Memorial Services cannot be held responsible for any damages or claims relating to any use of the obituary. We are committed to conducting our business in accordance with principles to ensure that the confidentiality of personal information is protected and maintained. We will not sell or in any other way distribute your personal information or any other information submitted on this formNOTICE*YES - I understand and accept the above terms and conditions CONTACT INFOYOUR NAME*YOUR E-MAIL*IMPORTANT: This is where the completed obituary will be sentYOUR PHONE (optional)Please enter your phone number If you would like us to contact you if we have any questions about the information entered.YOUR RELATIONSHIP TO THE DECEASED*Family MemberFriend of FamilyFuneral DirectorOtherPlease specifiy relationship with deceased* THE DECEASEDFull name of deceased*The full name as you would like it to appear in the obituary.Nicknameif anyReference NameIn various parts of the obituary, we will refer to the person by name. How would you like us to refer to him/her? Please use this box to indicate a specific reference. If left blank, we will use the persons nickname, or first name if there is no nickname.EXAMPLES:JackCheweyMr. JohnsonDr. JohnsonMrs. StewartFather GibbonsSister JoAge*Age at time of deathGender*MaleFemaleCity & State of residence (optional)This indicates the city/town where he/she was living at the time of death. Not where the death occurred, but where this person was living at the time of death. Later on, we will talk about other significant places where this person lived, worked, traveled. But for now, this is just where he/she was living at the time of death EXAMPLE: Carlsbad, CAUnique Characteristics in Personality/LifestyleUse this space to tell us about anything interesting, different or unique about his/her personality and or lifestyle.You can keep this brief. In fact, most people leave this section blank. Our writers will incorporate whatever you put into this section into the obituary. There is no need to go into a life story as elsewhere on this forms we will talk about his/her life experiences and accomplishments (places of residences, career, education, etc..). Death InfoThis section refers to the details regarding the death. Only share information that you are comfortable sharing.Example of how the information from this section might be used:"After a lengthy illness, Michael Jones, 80, of Spring Valley passed away on January 13, 2011 at his daughter home in San Diego .Date of Death*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920City / State of death (optional)If you would like to include the city of death, enter it here.EXAMPLES:Carlsbad, CACarlsbadCaliforniaPlace of Death (optional)This indicates the specific place where he/she died. EXAMPLES:At homeIn a hospitalElm Street HospitalSons HomeAdditional Information - DEATH (optional)This is entirely optional. You can use this box if you would like to include any additional information regarding the death.EXAMPLES:Short battle with cancerComplications from diabetesDied peacefully surrounded by familyDied unexpectedly while on a fishing tripDied after a lengthy illnessComplications from recent surgery EARLY LIFE INFOThis section focuses on the details of the persons early life. Everything in this section is optional.Enter only what you want to include in the obituary.Date of Birth (optional)If you do not know the full birthdate, enter what you know to be true and correct. Do not guess or estimate. If you do not know, leave blank.EXAMPLES:3/16/1933March 19331933March 16, 1933City, State of Birth (optional)Enter the city and state of birth, if known. If you don't know both the city and the state, then enter what you know to be true or correct. If you do not know either, then leave blank.EXAMPLES:Carlsbad, CACarlsbadCalif.Additional Info - BIRTHUse this box to include any interesting facts about this persons birth.EXAMPLES:He was born at Antelope Valley HospitalJohn was born on a cruise shipJohn couldn't wait to be born, and was delivered in the car on the way to the hospital.Was born at homeParentsIf you wish not to include parents names, do not enter the names and we will not make any references to parents. If you wish to include parent names, but would not like include whether or not they are still living, then select "Do Not Include" from the still living drop down box. In all other cases, parents will be indicated in the obituary as "survived by" or "predeceased". You do not need to list parents in the upcoming "predeceased" or "surviving" family member sections.Fathers Full Name (optional)Father still living?YesNoUnknown/Do not IncludeYear of Death (optional)Most obituaries don't include this information. But we can include it if you wish to share it.Mothers Full Maiden Name (optional)Mother still living?YesNoUnknown/Do not IncludeYear of Death (optional)Most obituaries don't include this information. But we can include it if you wish to share it. RESIDENCE TIME LINEUse this section for information relating to the different places he/she lived.REMEMBER: This information is optional. Any information will be used in the obituary. If there is anything that shouldn't be in the obituary, don't mention it on this page.RESIDENCE TIMELINENameLength of StayComments/stories Use this area to enter different location where he/she lived. It's best to list only the most important places that had the largest impact on his or her life.NAME - Enter the name of the town/city, state (or country) of residenceLENGTH OF STAY - Enter the years at this location. You enter it as a range of years (1960-1975). Or the number of years (26 years). You can also use general terms (Many years)(early childhood)(later years)Comments - Use the comments box to enter any information about this location. (example: Moved here when her father got a job)Click the "+" button to add new locations (6 max) SpousesUse this section for information relating to spouses.REMEMBER: Most questions are optional. Any information will be used in the obituary. If there is anything that shouldn't be in the obituary, don't mention it on this page.Are there any spouses (living or deceased) that should be mentioned in the obituary?Yes - A HusbandYes - A WifeNoWife's Married NameWife's Maiden NameHusbands NameMarriage Year# of Years Married...City/State of MarriageIs this spouse still living?YesNoYear of DeathAdditional Info - SpouseBriefly share any information about this marriage. (I.E., how did they meet? Describe their love for each other. Any amusing, funny or inspiring stories regarding this couple.Would you like to include another spouse (living or deceased)?Yes - Another HusbandYes - Another WifeNoWife's Married NameWife's Maiden NameHusbands NameMarriage Year# of Years Married...City/State of MarriageIs this spouse still living?YesNoYear of DeathAdditional Info - SpouseBriefly share any information about this marriage. (I.E., how did they meet? Describe their love for each other. Any amusing, funny or inspiring stories regarding this couple. FAMILY MEMBERSThis section is where you will indicate relatives of the deceased that will be mentioned in the obituary. You can add surviving (living) relatives, and pre-deceased (those who are no longer living) relatives.DO NOT include parents or spouses (we will use information from previous steps.)Pre-Deceased FamilyAre there any pre-deceased family members you would like to include in the obituary?YesNoUse this section to name up to six deceased family members. You may edit the written obituary to add additional relatives.Pre-Deceased RelativesNameRelation*Year of Death (optional) NAME - Name of relativeRELATION - Brother, Sister, Son, Daughter, etc.*YEAR of DEATH - Year that this relative died (Year of death for relatives is very rarely included in obituaries. Includ it only if you really think it should be included.)Click the "+" button to add additional relatives (6 max)# Of Pre-Deceased GrandchildrenPlease enter using numbers. If you would like to include names of grandchilden, you can use the "Additional Information - Family" box.GrandchildrenGreat-GrandchildrenGreat-Great-GrandchildrenSurviving FamilyAre there any surviving family members you would like to include in the obituary?YesNoUse this section to name up to ten surviving family members. You may edit the written obituary to add any additional relatives.Surviving RelativesNameRelationSpouses first nameCurrent Residence (city, state. or country) NAME - Name of relativeRELATIONSHIP - Brother, Sister, Son, Daughter, etc.Spouses first name - First name of relative's spouseCurrent Residence - City, state (or country) of where this relative is currently livingClick the "+" button to add additional relatives (10 max)# Of Surviving GrandchildrenPlease enter using numbers. If you would like to include names of grandchilden, you can use the "Additional Information - Family" box.GrandchildrenGreat-GrandchildrenGreat-Great-GrandchildrenAdditional information - FamilyUse this box to include any information about the family that you would like to include in the obituary.This should only be about family members of the deceased. Any interesting facts or stories about this persons family.Also, use this box if you do not want to name surviving relatives by name. You can specify surviving relatives by number (survived by 4 brothers, 2 sisters and one son).EXAMPLES"Was the grandson of Ernie Wilder, the first person to scale Arizona's Fielder Peak.""His brother, Bobby Critten plays short stop for the Florida Marlins.""Is the nephew of Dr. William Chase, local legend in dentistry." EDUCATIONUse this section to add information relating to educationHIGH SCHOOLCITY, STATEGRADUATION YEARAdditional Education - INFOUse this space to add information on colleges/universities attended, degrees earned, years of attendance, etc. And/Or any other achievements, awards, or interesting stories related to education. MILITARYIf the deceased was a member of the armed forces in any way. Please share the details in the box below.Military ExperienceAdd any information that you would like included in the obituary.Examples of what can be added: Branch of military, years of service, combat/conflict experience, rank, medals/awards, or any other interesting stories or details relating to military service. CAREERUse this section to share career information.Please share the most significant jobs/careers. These are the ones where most people would know him/her from.CAREER INFORMATIONUse this box to add information about careers and jobs. It is best to include only the most significant careers. Include only what you want to show in the obituary.You can include:Type of industryName of companyHow long at the companyJob duties/positionawards/achievements Memberships, Hobbies and InterestsUse this section to list any memberships, hobbies and interests that should be mentioned in the obituary.MembershipsWas the deceased a member of a church, club, association, community service group, etc...? Use this box to add information such as the name of the organization or church, and or any special notes or comments.Volunteer WorkDid the deceased do any volunteer work in the community...? Use this box to add information such as the name of the organization, the type of work, etc.Hobbies / InterestsDid the deceased have any hobbies or interests that he/she really enjoyed...? (examples: Gardening, quilting, running, bingo, playing guitar, etc). SERVICE INFORMATIONUse this section for any visitation, service, internment information.VISITATION/VIEWINGName of LocationAddressDate & Time Leave this blank if there is no visitation/viewing, or if you do not want to include in the obituary.SERVICE DETAILSWhat type of service will be held?*Do not include service information in the obituaryNonePrivateFuneralFuneral MassMilitaryGravesideMemorial ServiceCelebration of LifeOtherPlease specify the kind of service to be heldSERVICEName of LocationAddressDate & TimeOfficiant (optional) INTERNMENTName of Cemetery (or other place of internment)City, State (or Country) ADDITIONAL INFO - ServiceUse this box to add any additional information regarding the service. As an example, you can use this space to list additional services, like mass, vigil, etc. Or you can use this box to name pallbearers, special thanks, etc. ALMOST FINISHEDWe now have enough information to write a detailed obituary.But, there are two additional things that we would like to include. First, the name of the funeral director or funeral service who is helping with the arrangements. And we will give you another chance to add any additional information that wasn't added in the previous sections.FUNERAL DIRECTORName of Funeral Director/service who is helping the family with arrangementsCity, State (or Country) Memorial Funds / Donations informationUse this space to add any final information. Such as: Memorial funds established Memorial donation suggestions, (contact info - if known) Special thank you's to people, groups, or organizations SUBMITYou may review your entries and make any changes before submitting the form. Use the PREVIOUS and CONTINUE buttons to navigate between pages.IMPORTANT: Your form will not be submitted until you click SUBMIT below.Once submitted, you cannot access or make any changes to the form. If you need to make corrections, or if you have any questions or concerns, use the contact us page to get in contact with us.