Membership Form - Direct Cremation of the Seacoast | Serving New Hampshire & Massachusetts

What Does Our Free Membership Do?
It saves you and your family from the inflation of cremation costs. Unlike some cremation providers, we do not require a membership fee or payment in advance to lock in today’s price. Just complete the simple membership application below and receive your free membership card and lock in today’s price of $1250 for tomorrows need.
Member Name*
First Last
Member Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Member Email*
Member Phone*
Next of Kin*
First Last
Relationship to Member*
Next of Kin Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Next of Kin Email*
Next of Kin Phone*
Contact Regarding Membership*
- Member
- Next of Kin
Preferred Method of Contact*
- Email
- Phone
How did you hear about us?*
- Internet
- Referral/Friend
- Advertisement
- Other
How did you hear about us (Other)*
Email
This field is for validation purposes and should be left unchanged.