Pre-arrangement can be as easy as filling
out this form and submitting it, or printing a copy , completing
, and mailing it to:
Proko-Wall Funeral Home
Attn: MarLynn
1630 E. Mason St.
Green Bay WI 54302
800.750.4222
Please complete to your level of comfort.
Name:
First/Middle/
Last
Address:
City:
State:
Zip:
Email Address:
Birthdate:
Birthplace:
Social Security Number:
Education Level Completed (1-16):
Occupation:
Industry:
Military Service:
Branch:
War:
Enlisted:
Discharged:
Religion:
Church Affiliation:
Spouse's Name:
Father's Name:
Mother's Maiden Name:
Cemetery:
County:
Address:
City:
State:
Disposition:
Burial:
Entombment:
Cremation:
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