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 Middle 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 are to coordinate in notifying the Rosary Society and 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 (priest required)

Blessing Service only at funeral Home by funeral director (no priest required)

Graveside Service only at cemetery (priest required)

Graveside Service only at cemetery by funeral director (no priest required)

Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at both)

Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at funeral home only)

Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at cemetery only)

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

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 or Mausoleum (for casket interment / entombment)

Cemetery or Columbarium (for cremains interment / inurnment)

Interment / Inurnment Information *

Immediately following funeral service -- request priest to attend

Immediately following funeral service -- priest does not need to attend

private, at the convenience of the family

Is the Parish Center Activity Building needed for a post-funeral meal? *

Yes

No

If the use of the parish activity building for a post-funeral meal is requested by the family, the parish office and parish Funeral Ministry are to coordinate in making any necessary arrangements.

============= FOR PARISH OFFICE USE ONLY ================

Recorded in Sacramental Register

MM / DD / YYYY

Parish Bulletin / Lector Sheet

MM / DD / YYYY

Music Ministry Options (indicate all that apply)

Organist

Resurrection Choir / Cantor

No Music

If the use of the Music Ministry is required, the parish office and parish Funeral Ministry are to coordinate in notifying the appropriate person(s).