If you are considering cremation, did you visit our online urn gallery ?    No Yes

What type of services are you considering ?  Cremation Burial Immediate Burial Cremation With Viewing

How did you find or hear about us ?             Google Search Yahoo Search MSN Search Phone Book Newspaper Ad Friend Mailing Presentation we attended

What item is most important to you ?            None Cost Reputation Quality of Service Location Ease of Making Arrangements

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Your Name
 

Your Address
 

Your City                                                                        Your Zip
     Michigan            

Your Email Address                   
    

Would you like for us to contact in regards to this information,
or to set up an appointment  ?    Yes No

Your Phone Number
 

Any further questions or comments ?

  Yes, I would like to receive your email newsletter.  I understand that my email address will be used only
          by Veterans Funeral Care and that it will not be sold or given to any third party organization.