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Peaceful Rest Funeral Chapel

401 SW Harrison Street, Topeka, KS 66603

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:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded In Death
Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

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):
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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


 

 

 

 

Book of Memories

The pinnacle of memorialization, any family member or friends can take advantage of this free services by creating an account and a book to memorialize their loved one.

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

Dying is one of the few events in life that's certain to occur, yet one we rarely plan for. Should we spend more time preparing for a two week vacation than we do our last days on Earth?

Expressions of Sympathy

It can be difficult to find the right words, so we have hand-picked a collection of sympathy and remembrance gifts that will be cherished.

Order Flowers

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

Daily Grief Support by Email

Grieving doesn't always end with the funeral: subscribe to our free daily grief support email program, designed to help you a little bit every day, by filling out the form below.

Weekly Email Tips to Support a Grieving Friend

It's hard to know what to say when someone experiences loss. Our free weekly newsletter provides insights, quotes and messages on how to help during the first year.

Proudly Serving the Communities of Topeka, Lawrence, Manhattan, Olathe, Overland Park, Tonganoxie, Eudora, Leavenworth, St. Joe, Lenexa, Lee Summit, Mission, Kansas City, and Shawnee Mission.
785-234-1707 Peaceful Rest Funeral Chapel
401 SW Harrison Street
Topeka, KS 66603
Email: tyson@peacefulrestfuneralchapel.com
785-234-1707 Peaceful Rest Funeral Chapel
401 SW Harrison Street
Topeka, KS 66603
Email: tyson@peacefulrestfuneralchapel.com
785-234-1707 Peaceful Rest Funeral Chapel
401 SW Harrison Street
Topeka, KS 66603
Email: tyson@peacefulrestfuneralchapel.com
785-234-1707 Peaceful Rest Funeral Chapel
401 SW Harrison Street
Topeka, KS 66603
Email: tyson@peacefulrestfuneralchapel.com
785-234-1707 Peaceful Rest Funeral Chapel
401 SW Harrison Street
Topeka, KS 66603
Email: tyson@peacefulrestfuneralchapel.com