Preplanning Services

Pre-Need Funeral Arrangements Assure That Your Individual Wishes And Preferences Are Carried Out, It Also Helps Lighten The Difficult Burden From Your Family Members, Contact Us Anytime To Discuss Questions You May Have About Funeral Pre-Need Arrangements.

 

 

Preplanning On-line

You may prefer to use our online planning tool. Complete as much or as little of the form as you feel is appropriate. We have a check box at the bottom of the form instructing us to file the information, but not to contact you. Please check that box if you do not want us to contact you.

 

 

Obituary Email Notification

 

Hickey and Son Funeral Home now offers an obituary notification subscription. We will send an email to you when we post an obituary to the website. The email will contain a link to the obituary and a link allowing you to terminate your subscription.

We will not distribute your email address. Click the button below to subscribe to this service.

 

Preplanning On-Line

Personal Information

First Name:
Middle Name(s):
Last Name:
Telephone Number:
E-mail Address:
 
 
Address:
Town/City:
State:
Zip Code:
Date of Birth:
Place of Birth:
(city & state or county & state)
Marital Status:
Spouse's Name:
(Maiden name and full name of wife or husband's full name)
Occupation:
(for longest period during working life)
Social Security Number:
Father's Full Name:
Mother's Full Name:
(include her maiden name)

Person who will be in charge of my funeral arrangements:

Name (person in charge): 
Address (person in charge): 
Town/City (person in charge): 
State (person in charge): 
Zip Code (person in charge): 
Phone Number (person in charge): 

Military Information

Branch of Service:
Description of Service:
(Wars fought in, medals earned, military campaigns)
Veteran's Service Number: 
Rank: 
Discharge Papers Location:

Family Members

Spouse:
(Address and phone numbers)
Daughters:
(Hometowns and phone numbers)
Sons:
(Hometowns and phone numbers)
Grandchildren:
(Hometowns and phone numbers)
Sisters:
(Hometowns and phone numbers)
Brothers:
(Hometowns and phone numbers)
Other Relatives:
(List relation, hometowns, and phone numbers)

My Funeral Service Preferences

Place of Service:
(Funeral Home, Church, Graveside, or other)
Clergy:
(Minister's hometown and phone number)
Type of Disposition: Burial
Entombment
Cremation
Other (Describe Below)


Cemetery Property Owned? Yes No
Name of Cemetery:
(Include: Location of Cemetery, City, & State)
Cemetery Preference:
(If property not owned, include location of cemetery, city & state)
Music Selections:
(Organ or piano background, live vocal, or recorded music) )If live vocal, include the vocalist, and their phone number) (List of songs)
Pallbearers/Honorary Pallbearers:
(Include pallbearers hometown, home phone number, and bearer type designation)
(A = Active Bearer, H = Honorary Bearer)
Lodge, Society, Fraternal Organization:
(List involvement and if you would
like an honor guard)
Flowers:
Memorial Contributions / Donations:
Obituary Information:

(List education and place of schooling, wedding date and place, work history and places lived and worked, Clubs, Lodges, Hobbies, significant accomplishments, Boards, Committees and community and Church involvement, etc.)

Any information or special instructions not previously listed:

Please check as many of the following as apply.

Please contact me so that I may select my casket and vault in advance.
Please forward me a copy of my information for my records.
Please contact me if any of my submitted information needs clarification.
File my information for future reference at Hickey & Son Funeral Home, but please do not contact me.
I would like to discuss my pre-payment options with no obligation, please contact me.

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