Full Name of Deceased
Funeral/interment of cremated remains/monument/additional inscription on monument Funeral Burial Interment Monument Inscription
If monument, will it mark a burial plot, or an ashes interment plot? Burial Ashes
Familiar name
Date of death
Age at time of death
Address
Name of chief mourner
contact details of chief mourner
______________________________________________________
Service Details
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Date and time of service
Minister ---BarnabyHelenDouglasOther
If another minister, who?
Service in church Yes No
Committal Churchyard Crematorium Other Cemetery
Notes on location
Church organist required Yes No
Service Notes
Music in
Bible reading
Non Biblical reading
Family tribute? Yes No
Hymns
At crematorium, curtain at committal? Yes No N/A
Music out
Notes
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