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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:

 
Jimmy Bartlett
Born: 1/22/1935
Died: 11/14/2017
Margaret Andrews
Born: 12/29/1924
Died: 11/14/2017
Richard Ramirez
Born: 6/30/1972
Died: 11/5/2017
LaVerne Shaw
Born: 6/9/1927
Died: 11/4/2017
Frank Janousek
Born: 7/14/1940
Died: 11/4/2017
Jovita Muela
Born: 2/15/1950
Died: 11/3/2017
Freddie Chandler, Jr.
Born: 11/1/1972
Died: 10/28/2017
Emma Claunch
Born: 8/10/1933
Died: 10/27/2017
Ronald Nelson
Born: 3/15/1937
Died: 10/24/2017

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