Preneed Membership Form

For your convenience, we have provided online arrangements on our website. In accordance with state laws, all pre-need and at-need arrangements are handled and reviewed by the licensed staff of our Honored Provider firm. These online arrangements are not a substitute for the Statement of Goods and Services, required by law. These documents will be produced and given to you using the information submitted.

Name of individual who the arrangements are for*

If you are pre-plannig for your self this would be your name. If you are pre-planning for someone else this would be their name.
Street*
City*
State*
Zip*
Phone Number*
Email*
Date of Birth
MM slash DD slash YYYY
Simple Cremation Package Pre-plan
Basic Services
Price:
Services Included:
- Basic Services of Funeral Director & Staff
- Carved top Wooden Urn
- Refrigeration (3 days included, $150.00 per day after)
- Service Automobile
- Private “Good Bye” I.D. Viewing 30 mins (M-F 11am-4pm)
- Mailing of cremated remains included if desired.
- Transfer of your loved one into our care from facility or residence anywhere in the state.
- Cremation in Our Private Crematory
- Alternative Cremation Container
- 5-7 day processing time after obtaining authorization
- Mailing of cremated remains included if desired.
Breakdown of Basic Services:
- Services Included:
  - Basic Services of Funeral Director & Staff
  - Carved top Wooden Urn
  - Refrigeration (3 days included, $150.00 per day after)
  - Service Automobile
  - Private “Good Bye” I.D. Viewing 30 mins (M-F 11am-4pm)
  - Mailing of cremated remains included if desired.
  - Transfer of your loved one into our care from facility or residence anywhere in the state.
  - Cremation in Our Private Crematory
  - Alternative Cremation Container
  - 5-7 day processing time after obtaining authorization
  - Mailing of cremated remains included if desired.
Pre-need Packet Discount
Discount of $350 off the simple cremation package when the Pre-need packet is selected.
Price:
Cremation Merchandise Options
Cremation Casket
- Standard Cremation Container
- Wood Grain Cremation Container
These alternative containers allow for the family members to have a choice of container to house the deceased for the cremation or private viewing option. If you would like to choose another type of casket we have several selections such as veneer, pine, poplar, oak, cherry and mahogany. Please contact us and we can send you our full options via email.
Cremation Urns
- Temporary Plastic Urn
- Carved top Wooden Urn (included)
- Cherry Statesman Urn
- Sheet Bronze Urn
- Scattering Urn
- Cloisonne Urn
- Cultured Marble Urn
- Classic Pewter Urn
- Engraving
These urns represent our most popular choices. If you wish to see our full line of urns we would be pleased to send you our catalog.
Additional Options
Additional Options
- Pre-arrangment Package
  Select this package to claim your discount. This package will be delivered to your upon your pre-payment account being finalized. It will include membership ID cards, Certificate of membership and your wishes and pertinent information neatly filed in a personalized binder. Also included in this package is a How to Guide which will help you and your family through the many steps and choices which come at a time of need; such as dealing with social security, planning a service and handling financial affairs.
- Private “Good Bye” I.D. Viewing (included)
  Final Good-bye Viewing (un-embalmed) (includes use of facility for 30 minute viewing, for up to 10 immediate family members. M-Th. during normal business hours) Our staff will contact you to schedule.
- Do It Yourself Memorial Package
  A Personalized Guest Register Book, 100 Memorial Photo Cards, 50 Personalized Acknowlegdement cards and Envelopes. We Will contact you regarding your theme choices and to acquire the photo you want to use. Additional cards can be added at cost.
- Memorial DVD
  A DVD Slide Show using family photos set to music and motion. 50-100 photos. We will contact you to acquire the photos and music and to add additional DVD's to your purchase. Initial Purchase includes 2 DVDs. DVDs are not able to be copied or burned.
- Obituary Coordination and Submission (included)
  This charge does not included the actual charge of the newspaper to run the obituary. Those charges vary by the size of the obit and newspapers selected. We will provide you with a quote from the paper before final submission. The full price of the obituary will need to be paid by credit card prior to submission. This list does not include prices for certain items you may ask us to buy for you such as cemetery charges, newspaper notices, clergy fees and death certificates. The prices for those items will be shown on the statement describing the goods and services you selected.
Death Certificate*
Price: $20.00
(Veterans, and spouses of veterans should enter 0 / Zero as they are entitled to 20 free copies.)
County Coroner Cremation Permit*
Each county coroner requires that a cremation authorization permit be given prior to cremation. Most county coroners charge for this permit. Please pick the county in which the death occurred from the menu above.
Disposition Options
Disposition Options
- Release of Cremated Remains
  We will hold the cremated remains for three (3) days after the cremation is complete. During this period a local pick up can be arranged at our office. After three (3) days Cremated Remains will be carefully packaged and shipped via certified U.S. Mail to the informant as listed on the cremation Authorization any domestic destination. This will incur the normal mailing fee listed below.
- Mailing of Cremated Remains
  Cremated Remains will be carefully packaged and shipped via Express U.S. Mail to the informant as listed on the Cremation Authorization at any Pennsylvania address. Locations outside of PA will be charged the actual postage fee.
This list does not include prices for certain items you may ask us to buy for you such as cemetery charges, newspaper notices, clergy fees and death certificates. The prices for those items will be shown on the statement describing the goods and services you selected.
Total
$0.00
Payment Options*
- Pay in Full
- Payment Plan
- Pre-Plan only (No Pre-payment)
Please choose a payment option. By choosing to pay in full you will receive a discount.
Credit and Payment Policy
Corey Brian Strauch Funeral Home & Pennsylvania Cremation Services, LLC has established a uniform payment policy to serve all families fairly and to alleviate misunderstandings. A sound payment policy enables us to contain our cost to the families we serve. Our general payment policy is that the entire amount of services are due and payable prior to services being rendered. We accept cash, personal/bank checks and credit cards as forms of payment. We regret that we are unable to accept: Insurance policies, settlements of estates through attorney's or probate court, as means of financial arrangements
Other information
The following information is not required but will be needed to complete the various forms and important paperwork related to your cremation services. We will need to gather it at some point so why not do it now.
Social Security Number
Veteran*
- Yes
- No
Branch of Service
- Army
- Navy
- Air Force
- Marines
- Coast Guard
City of Birth
State of Birth
County of Residence
City, Boro or Township of residence
Father's full name
Mother's full maiden name
Marital Status
Full Name of Spouse
Race

(White, Black or African America, American Indian, Asian Indian, Other please specify)
Hispanic
- Yes
- No
Is the new member of Hispanic origin?
Highest Education Completed

(8th grade of less, 9 to 12 no diploma, GED or High School Grad, Some College, List Degree Achieved, Other please specify)
Occupation Before Retirement

What the new member did during most of working life - CANNOT USE RETIRED
Next of Kin (person in charge)
Next of Kin address
Next of Kin phone #
Next of Kin email address
Who should receive paperwork for completion?*
- Individual who the arrangements are for
- Next of Kin
Delivery method of paperwork*
- Email
- Postal Mail
Name
This field is for validation purposes and should be left unchanged.

The cost of cremation and the degree of service vary widely across Pennsylvania. We are NOT a high priced funeral home. We ARE a fully licensed cremation service provider and focus on the needs of the families we serve. In addition, we own our private crematory so that your loved one never leaves ... Continue Reading.

HAVE QUESTIONS?

Preneed Membership Form

Simple Cremation Package Pre-plan

Cremation Merchandise Options

Additional Options

Disposition Options

Credit and Payment Policy

Other information

About Us

Pennsylvania Area Weather

Recent Obituaries

Elizabeth Matlock

Susan McGeehan

Lorince Bernard Edwards

Stephen Caminiti

Sandra Dando

Robin Marie Ireton

Charles A. Notari

Diane Mason Davenport

Kathryn “Kay” Jones

Dalis Maris Melbarde

Obituary Notification Service

Preneed Membership Form

Simple Cremation Package Pre-plan

Cremation Merchandise Options

Additional Options

Disposition Options

Credit and Payment Policy

Other information

About Us

Pennsylvania Area Weather

Recent Obituaries

Obituary Notification Service

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