Funeral Request

DECEASED INFORMATION

FULL NAME OF DECEASED

ADDRESS

CITY/PROVINCE

DATE OF BIRTH


REQUESTOR INFORMATION

FULL NAME

ADDRESS

CITY/PROVINCE

PHONE
Primary (902) 555-5555

Work (902) 555-5555

Cell/Other (902) 555-5555

EMAIL ADDRESS


MEMBERSHIP AT EPUBC

Was the deceased a member of EPUBC?

Are you a member of EPUBC?

If not, what church are you a member of


FUNERAL & WAKE DETAILS

DATE AND TIME OF FUNERAL REQUESTED

DATE (YYYY-MM-DD)

TIME (2:00pm)


DATE AND TIME OF WAKE REQUESTED

DATE: (YYYY-MM-DD)

TIME (2:00pm)

RESPONSIBLE FUNERAL HOME

REPASS FOLLOWING FUNERAL?

BURIAL AT EAST PRESTON UNITED BAPTIST CHURCH CEMETERY?

COST: THERE IS A COST FOR THE USE OF THE CHURCH AND FOR THOSE FROM THE CHURCH WHO PARTICIPATE IN THE FUNERAL. A FULL LIST OF COSTS WILL BE PROVIDED TO YOU. THESE COSTS COULD INCLUDE THE COST OF USING THE CHURCH, UTILITIES USED, PASTOR OFFICIATING THE SERVICE, MUSICIAN AND/OR CHOIR, OTHER COSTS, ETC.
*COSTS MUST BE PAID IN FULL BEFORE FUNERAL.*

OTHER SERVICE REQUEST /DETAILS


Is everything correct?