Pre-Need Order Form

Please complete the form below to make Pre-Need arrangements with Trappist Caskets. If you are needing a casket within the next six months, do not use this form, instead please call us at 888-433-6934.

Purchaser Information

Name of Purchaser*

Address*

City/State/Zip*

Phone*

Casket Beneficiary Information (person who will use the casket)

Name of Casket Beneficiary*

Address*

City/State/Zip*

Beneficiary Date of Birth*

Age*

Social Security # of Beneficiary (last 4 digits only)*

NOTE: Purchaser and Beneficiary may or may not be the same person. If you are purchasing the casket for yourself, you are both the Purchaser and Beneficiary. If you are purchasing a casket for someone else (spouse, parent, etc.), the Purchaser and Beneficiary are two different people. The Beneficiary is the person who will use the casket.

Funeral Home Information

Name of Funeral Provider

Address

City/State/Zip

Phone

If the funeral provider is unknown, please indicate the likely shipping destination (City & State) of the casket:

Casket Model

Please indicate casket desired: Premium Rectangular Premium Shaped Simple Rectangular Simple Shaped

Wood Selection

Please indicate wood species: Walnut Oak Pine (Available only in Simple Caskets)

Cross Preference

Please indicate cross preference: With Cross on Lid Without Cross on Lid

How did you first learn about us?

Please tell us how you first learned about Trappist Caskets:

Privacy Guarantee

All personal information provided to Trappist Caskets will be securely protected and will be used exclusively for the above stated purposes. As cloistered monks, we are well practiced in the art of privacy.

Purchaser Information

Casket Beneficiary Information (person who will use the casket)

Funeral Home Information

Casket Model

Wood Selection

Cross Preference

How did you first learn about us?

Privacy Guarantee

Pre-Need Arrangements

Immediate Need

Your Rights in Buying a Trappist Casket

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