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Welcome to the AFD&MA, Inc.
Registration Form
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Title Preference
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Funeral Director #
Embalmer #
Apprentice Funeral Director License #
Allergies Apprentice #
Apprentice Embalmer License #
Firm Name
Mailing Address
Address
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Emergency Contact Name & Number
Certifications: (Check all that apply.)
CFSP
CPC
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What is your current certification?
Funeral Home Title:
Owner
Manager
General Employee
Funeral Director
Embalmer
Dietary Preferences: We will do our best to accommodate your dietary needs but cannot guarantee availability of choices.
Please circle your preferences below:
Seafood Allergies
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Vegetarian
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Food Allergies
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