EmailMe Form - Funeral Director Information Worksheet

Today's Date *

MM / DD / YYYY

Name of Deceased *

First Middle Last

Age of Deceased *

Date of Death *

MM / DD / YYYY

Requested Funeral Date

MM / DD / YYYY

Nearest Relative or Contact Person *

First Last

Relationship to the Deceased *

Contact Phone *

### - ### - ####

Contact Information

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Funeral Home in charge of arrangements *

Days and Times of Visitation / Viewing / Other Information or Comments

Date and Time of Vigil Service at Funeral Home (if requested by family)

If Vigil Services are requested by the family, the parish office and parish Funeral Ministry will coordinate it with the Ladies of Charity.

Date and Time of Funeral Service at Church or Funeral Home *

MM / DD / YYYY HH : MM AM/PM

Funeral Service *

Funeral Mass at St. Victor Church of Our Lady of the Lakes Parish (Bairdford)

Funeral Mass at Transfiguration Church of Our Lady of the Lakes Parish (Russellton)

Blessing Service only at funeral home

Graveside Service only at cemetery

Both blessing service at funeral home AND graveside service at cemetery

When preparing the obituary, Funeral Directors are asked to please indicate in the funeral notice and obituary the name and location of the specific church at which the funeral Mass will be celebrated. Our Lady of the Lakes Parish consists of both Saint Victor Church (Bairdford) and Transfiguration Church (Russellton).

Disposition of Remains *

casket at church

cremains at church

memorial service only (no remains at church)

No services in church (see "Funeral Service" section above)

This information is required in order for the sacristan and funeral ministry to properly prepare the church for any funeral services to be held there.

Cemetery/Mausoleum/Columbarium

Interment / Inurnment Information *

Immediately following funeral service

Private - at the convenience of the family

Is the Parish Center Activity Building needed for a funeral luncheon?

Yes

No

When at all possible, we will offer the Activity Building free of charge to families for a funeral luncheon. If there is a schedule conflict with the hall, a member of the funeral ministry team will communicate that to the family.

------------ FOR OFFICE USE ONLY ------------

Database Updated

Added to Funeral Spreadsheet

Recorded in Sacramental Book

Bulletin & POF