Preplan Your Funeral | Heppell Funeral Planning

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Who Is Heppell?

Why Pre-Arrange?

Why Wait to Pre-Arrange Your Funeral?

Now that you have conducted your research about funeral planning, the next step is to follow through and make your pre-arrangements. Please call 744-3595 to set a time to record your wishes in the comfort of your own home or at the funeral home. Or if you wish to make your arrangments online, please fill out the form below. For other Estate Planning, visit Private Matters and receive a $10 discount from Heppell Funeral Planning Ltd.

Advance Funeral Planning On-Line

Click here for printable PDF version which can be filled out by pen. PDF is Viewable through the Adobe Acrobat Reader, if you do not have the reader click here to install it.

Please select a location you would like to submit
the form below to from the drop down list:

Personal Information

First Name:
Middle Name:
Last Name:
Date of Birth:
Birthplace:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:
Email Address:

Father's Name:
Address - if living:
City:
State/Province:
Zip/Postal Code:

Mother's Maiden Name:
Address - if living:
City:
State/Province:
Zip/Postal Code:

Where were you raised and what schools did you attend?

Maiden Name of Spouse:
Date of Marriage:
Place:
If deceased, date of death:

Where have you lived during your adult life?

Name of children & their spouses, and their addresses

Child#1 Name:
Spouse's Name:
Address:
City:
State/Province:
Zip/Postal Code:

Child#2 Name:
Spouse's Name:
Address:
City:
State/Province:
Zip/Postal Code:

Child#3 Name:
Spouse's Name:
Address:
City:
State/Province:
Zip/Postal Code:

Child#4 Name:
Spouse's Name:
Address:
City:
State/Province:
Zip/Postal Code:

Child#5 Name:
Spouse's Name:
Address:
City:
State/Province:
Zip/Postal Code:

Current Number of Grandchildren:
Current Number of Great Grandchildren:

Names of surviving brothers & sisters and their addresses

Sibling#1 Name:
Address:
City:
State/Province:
Zip/Postal Code:

Sibling#2 Name:
Address:
City:
State/Province:
Zip/Postal Code:

Sibling#3 Name:
Address:
City:
State/Province:
Zip/Postal Code:

Sibling#4 Name:
Address:
City:
State/Province:
Zip/Postal Code:

Sibling#5 Name:
Address:
City:
State/Province:
Zip/Postal Code:

Preceded in death by

Occupation. Give the type of work done most of working life, even if retired.

Name of Employer:

If Retired, Date of Retirement:
Total years spent in your occupation:

Church affiliation & activities:

List membership in fraternal, civic, or professional organizations:

Did you serve in the military? Yes No

If yes, what branch:

List membership in fraternal, civic, or professional organizations:

Special events in my life not listed previously:

FUNERAL INSTRUCTIONS

Place of Service:

Minister:

Music Selections:

Organist:

Singer(s):

Singer#1:

Singer#2:

Singer#3:

Singer#4:

Singer#5:

Pallbearers:

Pallbearer#1:

Pallbearer#2:

Pallbearer#3:

Pallbearer#4:

Pallbearer#5:

Pallbearer#6:

Pallbearer#7:

Pallbearer#8:

Favorite Bible Selections:

Special Services (Military or Lodge)

Cemetery Information

Name of Cemetery:
Location City:
Lot is in the name of:
Section:
Lot:
Grave Space:

Casket and Burial Preferences

Casket:
Metal:
Wood:
Exterior Color:
Interior:
Burial Vault:

Authorized Persons to Arrange Final Details

Person#1 Name:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:

Person#2 Name:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:

Person#3 Name:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:

Person#4 Name:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:

Person#5 Name:
Address:
City:
State/Province:
Zip/Postal Code:
Phone:

My Special Wishes

Clothing, jewelry, etc.