Online Pre-Planning Form

There are numerous benefits to pre-planning a funeral, some of which include:

Provides peace of mind
Relieves your loved ones of unnecessary concern
Reflects your expressed wishes
Alleviates financial burden on your family

Please take a few minutes to fill out the Online Pre-planning form below. Once the information is submitted, a Hughes representative will review and file it and will be in touch with you to further discuss the details of your arrangements.

If you'd prefer, a printer-friendly version of this form is also available for you to download and fill out manually. CLICK HERE for further instructions and the download link, if interested.

NOTE: Fields marked with an asterisk ( * ) are required. Any information you submit will be held in the strictest confidence - we do not release any information to outside parties under any circumstances.

Information About the Person Completing this Form:

*First name
*Last name
Middle Name
*E-mail
Street Address
City
Country
State
Zip Code
Phone
Person for Whom I Am Pre-arranging:

Vital Information About the Person for Whom Pre-Plan Is Being Done:

Last Name:
First Name:
Middle Name:
Sex:
Marital Status
Social Security Number
Date of Birth
Place Of Birth:
Spouse's Full Name:
Spouse's Maiden Name:
Father's Full Name:
Mother's Name:
Mother's Maiden Name:

Work and Education:

Primary Education:
Secondary Education:
Usual occupation
Kind of business
Company

Military Records:

Branch of Service:
Serial Number:
Date Enlisted:
Rank At Discharge:
Date Discharged:
Discharge On File At:
Copy of Discharge Papers:	Yes
Name(s) of War(s)/Conflict(s) Toured:

Funeral Service Information:

Place of Service:
Name of Funeral Home:
Address:
Phone:
Place of Visitation:
I Prefer the Funeral Service To Be:
Viewing for Family:	Yes
Viewing for Friends:	Yes
Religious Denomination:
Place of Worship:
Lodge / Union:

Disposition Options:

I Prefer:
Cemetery:
Address:
Phone:
Selection:
I Have Made A Last Will And Testament:

Person(s) To Finalize Arrangements At Time of Death: Check here and skip this section if the person filling out this online form is also the person making the final arrangements.

Full Name:
Street Address:
City:
County:
State:
Zip Code:
Phone:

Other Information & Instructions:

Please list any other instruction or information you would like us to have:

Memorials & Charities:

Please list any memorials or donations to charity that you would like to declare:

Options:

Please select one of the options below:

Please Verify Numbers