CONTACT US   |   575-622-1121   |   MAP & DIRECTIONS    
Ballard Funeral Home
EASY FUNERAL PRE-PLANNING FORM
 

To be placed in the permanent files of Ballard Funeral Home.
*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:

 
Anthony Imburgia
Born: 6/5/1931
Died: 11/3/2017
James Applegate
Born: 1/19/1939
Died: 11/2/2017
Betty Worley
Born: 6/8/1929
Died: 10/30/2017
Nancy Hardcastle
Born: 8/21/1954
Died: 10/29/2017
Joyce Hughes
Born: 7/1/1928
Died: 10/26/2017
Crystal Vigil-Juarez
Born: 5/22/1978
Died: 10/21/2017
Sammye Goldston
Born: 9/29/1937
Died: 10/19/2017
William "Bill" McTeigue
Born: 2/16/1925
Died: 10/16/2017
Cheryl Herrington
Born: 8/27/1951
Died: 10/14/2017

Search Obituaries

 
Send Flowers What Can I Do?
Ballard Funeral Home | 910 South Main | Roswell, NM 88203 | 575-622-1121
©2017 Ballard Funeral Home | All Rights Reserved | Terms of Use | Privacy Policy | Site By Gemini Graphics Inc.