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Pre Need

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Receive FREE Preplanning Guide

Online Pre-Arrangement Form

There are numerous benefits to pre-arranging 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-arrangement form below. Once the information is submitted, a Beecher & Bennett representative will review and file it and will be in touch with you to further discuss the details of your arrangements.

Step 1 of 3

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Your Contact Information
Your Name*
First Last
Relationship
Your Email*
Your Address
Street Address City State ZIP Code
Best phone number at which to reach you*
I am Planning for
Do you have an appointment scheduled with one of our staff?
- Yes
- No

Vital Information
Name*
First Middle Last
Gender
- Male
- Female
Marital Status
- Married
- Never Married
- Widowed
- Divorced
Date of Birth
MM slash DD slash YYYY
City of Birth
State of Birth
Country of Birth
Full Name of Spouse
Place of Marriage
Date of Marriage
MM slash DD slash YYYY
Father's Full Name
Mother's Full Name
Mother's Full Maiden Name
Children
Sisters and Brothers
Work & Education
Highest Level of Education
Usual Occupation (most of life, not retired)
Type of Business
Company Name
Military Service
Were you/they ever in the U.S. Armed Forces?
- Yes
- No
(if no, continue to next section)
Is a copy of the discharge papers available?
- Yes
- No
(if yes, please bring for us to copy)
Branch of Service
Date Entered
MM slash DD slash YYYY
Date Discharged
MM slash DD slash YYYY
Honorable discharge?
- Yes
- No

Possible Service Information
Name of Service Location
Address of Service Location
Street Address Address Line 2 City State ZIP Code
Phone of Service Location
Place of Visitation
Prefer the Funeral Service to be
Viewing for Family
Viewing for Friends
Religious Denomination
Place of Worship
Lodge/Union
Special Instructions
Flower Preference
Music
Casket Bearers (6)
(please separate each name with a comma)
Jewelry
Glasses
Clothing
Please list any other instruction or information you would like us to have
Disposition Request
Disposition Will Be
If Cremation, Indicate Preference for Disposition of Ashes
Name of Church (if applicable)
Address of Church (if applicable)
Street Address Address Line 2 City State ZIP Code
Name of Cemetery (if applicable)
Address of Cemetery (if applicable)
Street Address Address Line 2 City State ZIP Code
Section and Location in Cemetery
I have made a last will and testament
- Yes
- No
Insurance Company
Advisor Phone
Type of Policy
Policy Number
Is there a legal will?
- Yes
- No
Is there a named Executor?
- Yes
- No
Executor's Name
Is there a Pre-arrangement Contract?
- Yes
- No
If yes, where is the contract located?
Have any pre-arrangements been made with any other firm?
- Yes
- No
By clicking submit you agree that the information you have submitted is accurate and correct.
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Email
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Hamden Location

2300 Whitney Avenue

Hamden, CT 06518

Meriden Location

48 Cook Avenue

Meriden, CT 06451

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