Funeral Request

If you have lost a loved one, we are here to walk with you through this difficult time. Please fill out the form below, and our pastoral team will reach out to provide support and begin planning the service.

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1. Full Name

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2. Phone Number

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3. Email Address

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4. Your Relationship To The Deceased?

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5. Full Name of Deceased?

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6. Date of Passing

Date

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7. Type Of Service Requested.

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8. Preferred Date & Time For Service?

Date
Time
Date
Time

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9. Location of Service

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10. Estimated Number of Attendees

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11. Would you like a church pastor to officiate the service?

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12. Funeral Home Name

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13. Funeral Home Address

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14. Funeral Home Contact Person

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15. Funeral Home Contact Phone Number

Important Notice
Due to space and staff limitations, we can no longer provide repass space following funeral or memorial services. We appreciate your understanding and are happy to provide recommendations for alternative locations if needed.

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16. Special Requests or Information We Should Know?

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17. I confirm that I have the authority to request this service on behalf of the family. (Required.)

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18. I understand that the church team will reach out to finalize details based on availability and church guidelines. (Required.)

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