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Chapel of Hope
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Chapel of Hope.
*Require fields

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
 
Family Member Information

Family Member #1

 
Funeral Arrangement Details
Person in charge of arrangements:
 
Place of service or gathering:
If Other, please specify:

 

Preference for final disposition:
If Other, please specify:
Cemetery:
Disposition of cremated body:
 

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?

 

Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

 
R. Braggs
Born: 12/23/1944
Died: 3/24/2017
Julio Moreno
Born: 9/13/1975
Died: 3/23/2017
Larry Squires
Born: 9/18/1932
Died: 3/22/2017
Shirley Ayers
Born: 7/12/1933
Died: 3/20/2017
Harlan Webb
Born: 3/9/1940
Died: 3/20/2017
William Alves, II
Born: 5/28/1957
Died: 3/20/2017
Robert Budrow
Born: 8/7/1938
Died: 3/16/2017
Roy Davis
Born: 7/9/1925
Died: 3/14/2017
Irma Maldonado
Born: 7/2/1958
Died: 3/10/2017

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Chapel of Hope | 3321 North Dal Paso | Hobbs, NM 88240 | 575-392-5683
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