• Funeral Liturgy Request Form

  This form is not accepting responses at this time.

  • Full Name of the Deceased Please enter valid data.
  • Date of Birth Please enter valid data.
  • Date of Death Please enter valid data.
  • Deceased's Next of Kin Please enter valid data.
  • Address Please enter valid data.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • How will the Deceased be Laid to Rest? Burial Cremation
  • Burial Date Immediately After Funeral After Luncheon Later Date
  • Name of funeral Home Please enter valid data.
  • Date and Time of Funeral Please enter valid data.
  • Contact Information
  • Contact Name for Funeral Coordination Please enter valid data.
  • Relation to the Deceased Please enter valid data.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Visitation Information
  • Will there be a Visitation? Yes No
  • If yes, where will the Visitation be Held? Please enter valid data.
  • What is the Date and Time of the Visitation? Please enter valid data.
  • Will the Rosary be Said at the Visitation? Yes No
  • If yes, who will be leading the Rosary during the Visitation? Please enter valid data.
  • Funeral Mass Information
  • Where will the Funeral Mass take place? Please enter valid data.
  • What is the date of the Funeral Mass? Please enter valid data.
  • What is the time of the Funeral Mass? Please enter valid data.
  • Who will be the celebrant of the Mass? Please enter valid data.
  • Will the Mass be livestreamed? Please enter valid data.
  • Music
  • Musician for the Funeral Please enter valid data.
  • Opening Hymn Please enter valid data.
  • Offertory Please enter valid data.
  • Communion Hymn Please enter valid data.
  • Recessional Hymn Please enter valid data.
  • Readings
  • 1st Reading Please enter valid data.
  • Reader 1 Family or Friend Parishioner
  • Psalm The Lord is My Shepherd The Lord is My Light and My Salvation Other
  • 2nd Reading Please enter valid data.
  • Reader 2 Family or Friend Parishioner
  • Reader of Intercessions Please enter valid data.
  • Gospel Please enter valid data.
  • Will Someone Bring up the Gifts? Yes No
  • Eulogy Yes No
  • Luncheon Information
  • Would you like a luncheon provided by the Altar society? Yes No
  • If yes, how many people do you expect to attend the luncheon? Please enter valid data.
  • Homily Information

  Submit

  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.