Collecting Memories Questionnaire for Eulogies

Collecting Memories

As you work through the questions below, be truthful - be authentic - don't leave anything
out that will help us get to know the one you knew so well. Please remember that we can only know your
loved one by what you to tell us. The more complete your answers, the better we
can tell his or her life story. The boxes will expand to accommodate all you want to say.
If some questions don't apply or you don't feel comfortable sharing, feel free to leave them blank.

As you remember and share, may your spirit begin to heal.

If you close this page, your responses will not be saved.
Please print before submitting.

The Essentials...

* Indicates required field

Your Name *

First

Last

He/she is my (relationship) *

Full Name of your loved one *

Your Email Address *

Did he/she have a Nickname? *

Your Phone Number *

How old was he/she? What was the date of his/her death? *

Date of the Funeral or Memorial Service *

Where will the service be held (venue). What is the name of the Funeral Home? *

Will you or someone else be reading the eulogy? If not you, who? Will this be the only eulogy at the service? *

If married, spouse's name? How many years were they married? Is he or she living? If not, when did he/she pass away? *

What are his/her parents names? Are they living? *

Helping us Get to Know Your Loved One...

If married, when and where did they meet (if you know)? Please share that story here. *

Did he/she have children? How many? *

Children's Names and Ages - Please indicate whether they are living. If step children, designate with an "S." *

Grandchildren? Names and Ages, please. *

Great Grandchildren? Names and Ages please: *

What kind of relationship did the grandchildren have with your loved one? *

Any other important inter-generational relationships? *

Names of siblings (Please designate whether they are living or deceased): *

Had he/she been ill for a while or did he/she die suddenly? What was the cause of death? Did he or she suffer? *

Was he/she living independently or in a nursing/rehab facility? *

What stories of his/her childhood did he/she tell? *

Any stories about teen and young adult years? *

What education level did he/she reach? What did he/she major in? *

Did he/she ever serve in the military? Which branch? Where? Any stories? *

Did he/she have a Facebook page? If it is still up, please give us the link. *

Did he/she have any obstacles to overcome in his/her life? *

How would you describe his/her outlook on life? Please describe as completely as possible. *

Would you describe him/her as quiet or outgoing or something else? *

What did he/she do for a living? For what company? For how long? Had he/she retired? *

Did he/she enjoy the work? Why and to what extent? *

Any other employments? *

Are there any stories about his/her work life that you remember? Share one or two. *

Name three things he/she enjoyed doing? *

What do you think he/she would say were the biggest achievements of his/her life (other than having and raising family)? *

What do you think he/she was most grateful for in life? *

What was the most important thing in life to him/her (other than family)? *

Do you think he/she had any regrets about his/her life? If so, what might they have been? *

Was he/she a religious person? If so, to what extent? Did he/she have a church or synagogue or mosque? *

Was he/she involved with any clubs or other organizations? Did he/she hold office? *

Who were his/her closest friends? How did they meet? What were their favorite things to do together? Are they living? *

What were his/her favorite pastimes or hobbies? What talents or skills did he/she have? *

What special memory of him/her do you have - something you did together or something he/she said or some quirk he/she had. *

What would you say might have been the greatest day or days of his/her life (other than children being born)? *

What three words (at least three - feel free to use more) do you think best describe him/her? What made you love him/her? *

Is there some phrase or words he/she always used - some expression uniquely his/hers? What did it mean? *

Is there something about him/her that most people at the memorial service probably wouldn't know? Perhaps a hidden talent or habit or way of doing something... *

Did he/she grow up in the city and state where the funeral will be held? If not, where was he/she raised? What brought him/her to this city? *

What trait or characteristic or value do you think he or she would most like to have passed on to the next generations? *

Did he/she have any pets? If so, please describe them. *

Did he/she enjoy music? What kind? Any favorite songs? *

How do you think he/she most influenced the lives of those he/she knew? *

If someone were to ask you what he/she was like, what would you say in one sentence? *

If he/she met a stranger for the first time, how do you think that stranger would describe him/her? *

Are there some things you think might be important for us to know about him/her that we haven't asked? *

If you were granted five more minutes with him/her, what would you say? *

It is often helpful to our writers to talk to you over the phone if clarifications are needed. What would be the best time to call? Which time zone are you in? *

Please print before submitting.
If you do not receive a confirmation email within four hours, please call Steve at (734) 846-3072.

Submit