Print this page, complete, and mail to:
Funeral Consumer Alliance of Connecticut Inc. [FCA of CT Inc.]
P.O. Box 34, Bridgewater, CT 06752
Dear FCA of CT:
Yes. I want to become a lifetime member. Enclosed is:
____ $35.00 for single individual
____ $50.00 for family (spouses/partners, minor & elderly dependents)
____ $10.00 for transfers from other Affiliates (1 workbook and forms included)
____ $12.00 for any additional “Before I Go” packets (1st packet is free for single membership, 2nd packet is free for family membership).
$______ Tax deductible contribution
$______ Total enclosed [Make check payable to: “FCA of CT Inc.”]
_________________________________________________________________________
Name(s) (please print clearly)
_________________________________________________________________________
Address
_________________________________________________________________________
Phone number E-mail address
_________________________________________________________________________
Family membership only: Name(s) and birthyear(s) of dependents (Year of birth only)
_________________________________________________________________________
Signature(s) and date
In addition to the free “Before I Go” packet, please send the materials checked below.
PAMPHLETS AND FLIERS:
____ A Guide to Funeral Planning
____ Body Donation
____ Common Funeral Myths
____ Cremation Explained
____ Dead Lines, Obituaries, and Death Notices
____ Death Away from Home
____ Death in One State, Burial in Another
____ Did You Forget?
____ Directory of Societies
____ Earth Burial
____ Eco Friendly Death and Choices
____ Four Step Funeral Planning
____ Going Green
____ How to File a Funeral or Cemetery Complaint
____ How to Help Grieving People
____ Light, Like the Sun (on Cremation)
____ No One Wants to Talk about Death
____ Organ Donation
____ Prepaying Your Funeral
____ Recycle Your Medical Devices
____ “Simple and Cheap” (our article)
____ Ten Tips for Saving Funeral $$$
____ 12 Reasons People Spend Too Much
____ Understanding Funeral Trade Tricks
____ Veterans Benefits
____ Viewing and Visitation
____ What to do with the Ashes?
____ What to know on Embalming
FORMS:
____ Connecticut Advanced Directives for Health care: Explanation, Living Will, Attorney in Fact for Health care, Witness Form.
Body Donation information and forms: (pick one)
____ Yale University Medical School Body Donation information and forms
____ U. of Connecticut Farmington Body Donation information and forms
Organ/Tissue Donation information and forms: (pick one)
____ Yale University Medical School Organ/Tissue Donation information and form
____ U. of Connecticut Medical School Organ/Tissue Donation information and form
Most Recent Price Survey: Results and Notes for three towns / cities.
[1] ___________________ [2] ___________________ [3] ___________________
____ Short list of less costly cremation establishments around the state
____ Short list of less costly direct burial establishments around the state
____ Additional “Before I Go, You Should Know” checklist packets:
(1st packet free with single membership, 2nd is free with family membership, additional packets $7 each, with member discount):
And, to help FCA in the year ahead:
Please send me _____ Membership Brochures to distribute to friends
I wish to contribute to FCA, Enclosed is an additional $_________
I want to volunteer:
____ Board of Trustees ____ Information & Workshops ____ Newsletter Committee
____ Monitoring Legislation & Funeral Board Committee ____ Price Survey Committee