Michigan Cremation and Burial Services

Information Request Form

Please complete this information request form to receive our FREE, no obligation packet on
Michigan Cremation & Burial Services and costs. If you have further questions or need immediate
assistance please call us at 810 793-6234

NOTE: DUE TO THE LARGE NUMBER OF REQUESTS, WE HAVE LIMITED DISTRIBUTION TO THE STATE OF MICHIGAN ONLY.

Information Request Form

What type of services are you considering ?

If you are considering cremation, did you visit our online urn gallery ?

How did you find or hear about us ?

What item is most important to you ?

Where do we mail the requested materials ?

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 ?

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 Michigan Cremation & Burial Services and that it will not be sold or given
to any third party organization.