'ROCKY POINT FUNERAL HOME' Pre-Arrangement Information
ONLY SUBMIT INFORMATION YOU ARE COMFORTABLE GIVING.
Basic information needed to help you make arrangements:
Complete the form below and we'll get back to you as soon as possible. 
Place of Birth

Thank you
Name:          
Address:          
Phone:          
E-mail:          
Date of Birth

Served in the US Armed Forces? If yes specify years

Education (Highest year of School Completed
Social Security Number

Marital Status

Usual Occupation

Kind of Business or Industry

Name & Locality of Company or Firm

Your Father's Name

Your Mother's Name & Maiden Name

Name of Cemetery

Cemetery Information

Section

Range

Grave

Other

OR PRINT & MAIL TO:
Rocky Point Funeral Home
603 Route 25A
Rocky Point, NY 11778
OR Fax TO:(631)821-9050