Online At-Need Funeral Planning

Michael J Ambruso Funeral Director, Inc.

1175 South State Street

Dover, DE 19901

Phone: (302) 734-2281

Fax: (302) 678-1176

Email: ambruso@aol.com

Immediate Need

If you have immediate need of our services, we're available for you 24 hours a day.

Obituaries & Tributes

It is not always possible to pay respects in person, so we hope that this small token will help.

Pre-Arrangement

A gift to your family, sparing them hard decisions at an emotional time.

Order Flowers

Offer a gift of comfort and beauty to a family suffering from loss.

Online At-Need Funeral Planning

You can get a head start on the process by completing as much of this online form as possible. We recognize you may not know everything right at this moment, but what you do know will be invaluable to your Funeral Director. Submitting this form will surely expedite the funeral arrangement process.

I. Biographical Information

Full Name:

Date of Death:

Address1

Address2:

City Name:

State:

Zip Code:

Telephone Number: (xxx-xxx-xxxx)

Email Address:

Date of Birth: (month/day/year)

City of Birth:

State of Birth:

Highest Education Level:

Please select Grade/Years of Education completed:

Social Security Number:

For security reasons, we will contact you to complete the pre-arrangement.

Residence History:

Father's Name:

Mother's Name:

Mother's Maiden Name:

Spouse's Name:

Spouse's Maiden Name:

Survivors' Names and Cities of Residence

Relatives Who Have Preceded In Death

Occupation:

Industry:

Church Membership:

II. Military Record

Veteran:

Branch of Service:

Serial Number:

Date Enlisted: (month/day/year)

Date of Discharge: (month/day/year)

Rank at Discharge:

Location of a Copy of Discharge (DD214):

Military Honors at Graveside:

III. Service Preferences

Person in Charge of Arrangements:

Disposition:

Miscellaneous Notes and Instructions:

Please select one of the options below:
Please send me information
Please contact me to schedule an appointment
Please place my information on file

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Michael J Ambruso Funeral Director, Inc.

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Immediate Need

Obituaries & Tributes

Pre-Arrangement

Order Flowers

Online At-Need Funeral Planning

Social Security Number: