Pre-Planning (Funeral Home)
Immediate Need
Cremation Authorization
Vital Statistics
Contact Us
Acquisitions
Submit a Testimonial
Information for Death Certificates
Obituary Information
Program Information
Pre-Planning (Crematory)
Ask the Funeral Director
Pre-Planning (Funeral Home) – McCorkle
Tjfluehr Newsletter
Giving Back
Prearrangement Transfer
Immediate Need Mid Maine
Pay for Services Mid Maine
Free Planning Guide
Payment
Gather Website Questionnaire
✕
Hidden
Domain
Your Information
First Name
(Required)
Last Name*
(Required)
Your Email*
(Required)
Phone Number*
(Required)
If you are not responsible for arrangements, let us know who will be
First Name
(Required)
Last Name*
(Required)
Email
(Required)
Phone
(Required)
Deceased's Information
First Name
(Required)
Last Name*
(Required)
Are you a legal representative of this individual?
(Required)
Yes
No
ie. Power of attorney for healthcare, court appointed personal representative, etc.
Birth Place
Gender:
Male
Female
Ethnicity
Marital Status:
Married
Single
Widowed
Date
MM slash DD slash YYYY
City of Birth
State of Birth
Country of Birth
Country of Death
Place of Death
Occupation
Industry
Please Specify Address
Address
Street Address
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Family Information
Surviving Spouse
Maiden Name
Any other information?
CAPTCHA