Please enable JavaScript in your browser to complete this form.FUNERAL HOME INFORMATIONPlease provide the name of the Funeral Home handling the services. Name of Funeral HomeContact Name at Funeral HomeFuneral Home Contact Phone NumberFuneral Home Email AddressDECEDENT INFORMATIONName of Decedent *Date of Birth:Date of Passing: CONTACT INFORMATIONName of Family Member or Funeral Home Employee Responsible for completing Arrangements/Approvals Contact Full Name *Contact Email Address *Contact Phone Number *SERVICE INFORMATIONNAME AND TITLE OF THE PASTOR/CELEBRANT/REV/OFFICIANTTitleNo titleEvangelistElderBishopDeaconMr.Mrs.Miss.Ms.Dr.Prof.Rev.First NameLast NameName of Service LocationService Location (Address)Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDay of Week for ServiceMondayTuesdayWednesdayThursdayFridaySaturdaySundayMonday, Tuesday, etc.Date Of Service *Time of VisitationTime of ServiceBURIAL/INTERMENTWill There Be a Burial/Interment?YesDate / TimeName of Interment LocationAddress of Interment LocationAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeREPASTWill There Be A Repast?YesName of Repast LocationAddress of Repast LocationAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeOBITUARY HEADERPlease Select an Obituary HeaderSelect Obituary HeaderCelebrating a Life Well Lived...Celebrating the Legacy of...Celebrating the Life of ...Homegoing CelebrationHonoring the Life of...In Great Appreciation of...In Loving Memory of...Other (Please Specify)WHAT IS YOUR PREFERRED COLOR SCHEME?Please Indicate a Maximum of Two ColorsOBITUARY TEXT & ORDER OF SERVICEOBITUARY TEXT | Type or Paste TextORDER OF SERVICE | Type or Paste TextPOEM OR TRIBUTEWould You Like A Poem Or Tribute?YesSelect a Poem or Tribute1. I'M FREE2. MISS ME BUT LET ME GO3. COME WITH ME4. THE LORD'S PRAYER5. PSALM 236. FOOTPRINTS7. Serenity Prayer8. Mother9. Mother or Father10. Child11. Sister12. BrotherFLOWER BEARERS, PALLBEARERS, HONORARY PALLBEARERSList the Names of Flower BearersAdd comma separated names.List the Names of PallbearersAdd comma separated names.List the Names of Honorary PallbearersAdd comma separated names.ACKNOWLEDGEMENTSAcknowledgement of ThanksPlease select an Acknowledgement1. The family of the late (______) acknowledges, with sincere appreciation, your understanding, your prayers and all acts of kindness shown at this time of bereavement.2. The family of the late (______)sincerely appreciates your thoughtfulness and prayers during their time of sorrow. May God Bless you always.3. The family wishes to express their sincere gratitude for the many deeds of kindness shown during their time of sorrow. May God be with you always.4. With sincere appreciation, we wish to thank our many friends for their expressions of kindness during our bereavement for our loved one. May God Bless each of you. ~ The Family5. The family of (______) wishes to acknowledge with deep appreciation all acts of kindness, calls, cards, condolences, prayers and any other expressions of kindness in our time of sorrow. May God Bless you all.6. We the family of (_______), wish to express our deepest gratitude for the outpouring of love and support during our time of bereavement. The many acts of kindness, sympathy, prayers, visits, and telephone calls helped sustain us and have not gone unnoticed.Other Acknowledgement (Please Specify)Acknowledgement OtherCOVER PHOTOS AND ADDITIONAL IMAGES.In this section you may upload your images. Otherwise, please click "Save and Continue Later". Cover Photo(s)Please upload at least one (1) Cover Photo for the Obituary. You may select multiple files if you are using more than one photograph. Allowed Files Types: jpg,pdf,gif,png,heic.Additional ImagesAdditional Images may be upload here.Additional Notes Regarding Your OrderWebsiteSubmit
