Schedule a Funeral

Decedent Information

First Name*

Please provide the name(s) that will appear on the gravestone.

Middle Name

Invalid Input

Last Name*

Please provide the last name of the decedent.

Religion

Please provide a valid religion.

Gender*

Please select a valid gender.

Date of Birth*

Please provide the decedents date of birth.

Date of Death*

Please select a valid date of death.

Cause of Death

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Disposition Certificate

Please upload a PDF copy of the Disposition Certificate.

Veteran Information

Veteran?*

Yes

Please choose the decedents veteran status.

In War

Invalid Input

Branch of Service

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Burial Plot Information

Cemetery Number

Please select a valid cemetery number.

Section

Please select a valid Cemetery 1 Section.

Section

Please select a valid Cemetery 2 Section.

Section

Please select a valid Cemetery 2 Section.

Section

Please select a valid Cemetery 2 Section.

Block

Please select a valid block.

Block

Please select a valid block.

Block

Please select a valid Cemetery 3 Block.

Block

Please select a valid Cemetery 3 Block.

Lot

Invalid Input

Lot

Invalid Input

Lot

Invalid Input

Lot

Invalid Input

Additional Notes

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Funeral Information

Funeral Home*

Please provide your funeral home name.

Funeral Director*

Please provide the funeral directors name.

Phone Number*

Please provide a contact number for the Funeral Director.

Email Address*

Please provide a valid email address for the funeral home or funeral director.

Burial Type*

Please select the funeral type.

Select a Payment Method

Pay by check at the time of the service.

Pay now with a credit or debit card.

Select a valid payment option.

Graveside Date/Time*

Please select a valid date and time of when you expect to be graveside.

Estimated Completion Time*

Please select a valid estimated date and time of when you expect the service to end.

Opening, Closing & Setup Fee

0.00 USD

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Scheduling Notes:

Min. 3 days notice required.
Only 1 interment per day permitted.
(unless you call to make arrangements)
You must be on cemetery grounds before 3PM.
(unless you call to make arrangements)
Check the calendar below for availability.

sun

mon

tue

wed

thu

fri

sat

10 May

11:00 - 11:30

Funeral - Yocom, Roselyn
55 Church St., Hamburg PA 19526
15 May

07:00 - 13:00

Unavailable

Next of Kin Contact Information

Name

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Mailing Address*

Please provide a valid mailing street address.

City*

Please provide a valid city.

State*

Please provide a valid point of contact state.

Zip Code*

Please provide a valid point of contact zip code.

Phone Number

Please provide a valid point of contact phone number.

Email Address

Please provide a valid email address.

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