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Last Name:
First Name:
Middle Name:
E-mail:
Address:
City:
County:
State:
Zip Code:
Phone:
Marital Status:    
Date of Birth: Place Of Birth:
Spouse's Name: Spouse's Maiden Name:
Place of Marriage: Date of Marriage:
Father's Name: Mother's Name:
Mother's Maiden Name:
Education (0-12):
College 1-5+:
Occupation:
Business:
Company:
Branch of Service: Serial Number:
Date Enlisted: Rank At Discharge:
Date Discharged: Discharge On File At:
Copy of Discharge Papers:    Yes    No
Name Of  Wars:
Place Of Service:
Funeral Home:
Address:
Phone:
Place of Visitation:
Religious Denomination:
Place Of Worship:
Lodge / Union:
Person in Charge of Final Arrangements:
Flower Preference:
Music
Casket Bearers (6):
Jewelry:
Glasses:
Clothing:
Other:
I Prefer:
Cemetery:
Address:
Phone:
Section:
Location:
I have made a last will and testament:    Yes    No
Please list any other instructions you may have:
Please list any Memorials or Donations to Charity that you would like:
Please select one of the options below:
Send information about pre-arrangement
Contact me to set an appointment
Please keep my information on file

 


info@bollmanfuneralhome.com

 

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We understand that it is not always possible to pay respects in person, & hope that this small token will help. You can search for your loved one using the form below.

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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.

Prearrangement

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?

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 Dallas, Monmouth, Indpendence, Salem, Grand Ronde, Sheridan, and Amity
(503) 623-3286 Bollman Funeral Home
694 Main Street
Dallas, OR 97338
Email: (503) 623-2325 Dallas Mortuary Tribute Center
287 SW Washington St
Dallas, OR 97338
Email: (503) 623-3286 Bollman Funeral Home
694 Main Street
Dallas, OR 97338
Email: (503) 623-3286 Bollman Funeral Home
694 Main Street
Dallas, OR 97338
Email: (503) 623-3286 Bollman Funeral Home
694 Main Street
Dallas, OR 97338
Email: