Funeral Ceremony

Your Information

Your Name*

Address*

City*

State*

Zip*

Phone 1*

Mobile Home Work

Phone 2

Optional

Mobile Home Work

Email*

Are you a member of this church?*

Yes No

Funeral Information

Name of Deceased*

Death Date*

Was the deceased a member of this church?*

Yes No

Proposed Funeral Date*

Proposed Funeral Time*

Start Time

End Time

Will there be a family hour?*

Yes No

Expected Reception Attendees How many people are you expecting for the reception?

Funeral Home Information

Funeral Home Name*

Funeral Director's Name*

Address*

City*

State*

Zip*

Phone*

Mobile Home Work

Email*

Funeral Needs

Minister Needed?*

Yes No

Do you need a minister to perform the funeral?

Musician Needed?*

Yes No

Do you need a musician for the funeral?

Special Music Needed?*

Yes No

Do you need special music for the funeral?

Church Reception?*

Yes No

Do you desire to have the reception at the church?

Caterer Name*

Caterer's Phone Optional

Funeral Ceremony

Funeral Ceremony

🕊️ Funeral Ceremony Request

Your Information

Funeral Information

Funeral Home Information

Funeral Needs