My Life Legacy and Statement of Personal Principles

Please fill out the form below. If you prefer to print and mail this form. Click here for print option.

First Name*

Last Name*

E-mail Address*

A copy of this form will be sent to you.

Phone Number

Area CodePhone Number

E-mail Address(es) of your recipients

Statement of Principles

Your Life Legacy

Personal Favorite Memories

Quotations from famous people I admire

List of my favorite music to be played at my memorial/life celebration:

When your life is celebrated by family and friends, what theme best conveys your way of life (example; sports, tropical, western, birthplace, favorite colors, nature, favorite animals, science, hobby, interests, profession, etc.)?

What would you like to have placed on your honoring table aside from photographs (Example: veteran’s flag, flowers– if so, list the type, art, books, certificates, etc.)?

Are there any photos that would convey exactly the type legacy you would like to be remembered for? Please describe and or create a file to be kept with your important papers.

Do you have a specific location to recommend to your survivors in which your Life Memorial should be held (Country Club, Veterans Hall, favorite restaurant, hotel, etc.)?

Is there a favorite food that you think people attending your memorial would enjoy and associate with you?

Are there any regrets or apologies that need to be conveyed?

Do you have any words of wisdom to bestow upon the attendees of your life memorial/funeral?

Do you have any messages of thanks to any particular person? If so, please provide the name and message.

Do you have any specific gifts (heirlooms, collections, papers, clothing items, etc.) that you would like presented to family members? If so, please provide names and a description of the items.

I want my body to be disposed of by:

If you have chosen cremation, where do you want your ashes spread?

Enter the word below:*

Reminders:

Thank you for filing out this questionnaire. Secular Celebrations, would like to take this opportunity to remind you to write a will to avoid difficulties for your survivors. Please also consult your attorney or a trusted friend to help you file much needed paperwork such as “Power of Attorney,” “Advance Health Care Directive,” “Do Not Resuscitate” (if that is your desire) and “Bank Authorization Forms.”

Also, remember to write down your passwords (computers, phones, bank information, etc.) to make it easier for your survivors to conduct business after your death. Place this important information in a safe place that can be found by your family or attorney.

Would you like more information on how Margaret Downey could conduct your funeral/memorial/celebration of life?

Yes, Please send me some information.

A copy of this form will be sent to the email you provided. If you prefer, you can print the form using the button above and mail it to:

Secular Celebrations
C/o (Your Secular Celebrations Officiants Name)
P. O. Box 242
Pocopson, PA 19366

My Life Legacy and Statement of Personal Principles

Information about your recipients

Your Life Legacy