Become a Member

When you become a member of Cremation Society of Kansas & Missouri, your wishes are permanently on file with our offices, so in the event of your passing, your loved ones will know who to contact and the arrangements you prefer for your memorial. This allows your family and friends peace of mind knowing that you are being cared for the way you wanted. Take a moment to fill out our simple membership form. Once completed, one of our counselors will contact you and walk you through the rest of the process.

Information required for Membership

First Name:
Middle Name:
Last Name:
Sex:
Date of Birth:
Race:	(e.g., White, Black, American Indian)
Origin or Descent:	(e.g., Italian, Mexica, German, Puerto Rica, English, Cuban, etc)
City of Birth:
State of Birth:
Citizen of What Country:
Highest Education Level:
Marital Status:
Surviving Spouse's Name:	(if wife, give maiden name)
Was Decedent ever in U.S. Armed Forces?:
Social Security Number:
Usual Occupation:	(Give kind of work done during most of working life, even if retired).
Kind of Business/Industry:
Street Address:
City or Town:
State:
Zip Code:
	County:
	Inside City Limits?
Informant's Phone Number (Optional)
Informant's Email Address
Verification Code:

The amount that will be charged is :$25.00

Parents' Information

Father's Name:	(First, Middle, Last).)
Mother's Name:	(First, Middle, Maiden Last)

Informant's Information

Person Providing Information
Informant's Name:
Mailing Address:
	Number and Street :
	City or Town:
	State:
	Zip Code

Other Comments

Please list any other instructions or information you would like us to have:

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