*required information
Name of Deceased
*
Your name
*
Address
*
City
*
State
*
Zip
*
Email
*
Home Phone
*
Alternate Phone
Proposed Funeral Date
*
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2008
2009
2010
2011
Proposed Funeral Time
*
Start Time
| End Time
Will there be a family hour?
*
Yes
No
Proposed Family Hour Time
Start Time
| End Time
Are you a member of this church or was the deceased a member?
*
Yes
No
Do you need a musician for the funeral?
*
Yes
No
Do you need special music for the funeral?
*
Yes
No
Was the deceased a member of SBCC?
*
Member
Non-Member
Who would you like to perform the eulogy?
*
Do you desire to have your reception at the church?
*
Yes
No
Who will cater the event?
*
Caterer’s Phone #
How many people are you expecting for the reception?
Security Code
*