Name
*
First Name
Last Name
Email Address
*
Mailing Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Designated Obituary Author
Special instructions.
Name of Newspapers for Death and Funeral Notice
Include contact information.
Gifts
Name and Address of Charitable Organization
*If appliacable
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Military Service
Army
Army Reserve
Army national Guard
Marine Corps Reserve
Navy Reserve
Air Force Reserve
Air National Guard
Coast Guard
Specific groups or organizations that you would want to make your passing known
Alumni groups, military groups, charitable organizations, clubs, etc.
Preference
Burial
Cremation
Service
Religious
Non-Religious
Location of Funeral Home or Service Venue
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Calling Hours
No Viewing
One day Viewing
Two Day Viewing
Viewing Preference
Open Casket
Closed Casket
Wardrobe/Hair/Make-up/Jewelry Instruction
Items to be included in or on casket
Prayer Card One
Front Image/Back Prayer, passage or quote.
Image Source:
Title:
Source:
Prayer Card Two
Front Image/Back Prayer, passage or quote.
Image Source:
Title:
Source:
Photograph and Memorabilia placement instructions
Please check yes or no if you have created a folder with preferred photographs and memorabilia. Please note folder location on submission form.
Music Playlist for Wake
Please note in order with instruction.
Would you like a video presentation during calling hours?
Yes
No
Video Producer
If yes, please note where preferred images are stored and how family can get access to those images. Please include a music playlist. Please designate an individual to be in charge of this production.
Special Instructions not noted in above options
Location of Funeral Service or Mass
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Officient
Pallbearers
Please include name and contact information.
First Reading
Name:
Contact information:
Reading:
Second Reading
Name:
Contact information:
Reading:
Music Play List for Mass or Service
Please include special instruction including name of song, hymn or piece of music as well as preferred instruments.
Eulogy
I would like the following individuals to deliver eulogies at my service/mass.
Funeral Procession Route
Final Resting Place
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Special Instruction for Cremation
Tombstone Preferences and Epitaph
WAKE
No Reception
Lunch Reception
Dinner Reception
Special Instructions for Wake
Venue, menu, music, dessert. liquor, toast.
Self-Penned Toast
Please include who you would like to deliver this toast.
Toast
I would like the following individuals to deliver a toast at my wake.