Funeral Questionnaire

Copy and paste the questionnaire into an email window: that will make it possible for you to answer the questions. Then return to me at: [email protected]

Name of Deceased:

Birthplace: 

Last Residence:

Date of Birth:

Date of Death

Parents' Names:

Spouse:

Children:

Siblings:

Church Affiliation, if any:

Community Involvements:

Hobbies:

What memories do you treasure and would like to share about the deceased?

Funeral Home in charge of arrangements [include address, phone]:

Name, phone, e-mail address of contact person for this information 

Fees will be arranged by the funeral home.