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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:

 
Jesus Duran
Born: 4/29/1966
Died: 5/18/2017
Wilma Wilson
Born: 1/5/1934
Died: 5/17/2017
Ronald Martin
Born: 9/2/1941
Died: 5/17/2017
Steven Prather
Born: 8/29/1957
Died: 5/13/2017
Barnie Freeman
Born: 11/30/1962
Died: 5/11/2017
Edin Calderon-Gutierrez
Born: 3/31/1992
Died: 5/11/2017
Vera Branam
Born: 7/4/1926
Died: 5/9/2017
Gary Heady
Born: 9/3/1956
Died: 5/5/2017
Elias Doporto
Born: 12/5/1936
Died: 5/4/2017

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