Funeral and Memorial Planner

Name of Deceased Name of Deceased First Last
Date of Death Date of Death / MM / DD YYYY
Date of Birth Date of Birth / MM / DD YYYY
Name of Family Contact Name of Family Contact First Last
Family Contact Phone Number Family Contact Phone Number - ### - ### ####
Memorial Designations

e.g., Donations in lieu of Flowers
Date of Service Date of Service / MM / DD YYYY
Time of Service Time of Service : HH MM AM/PM
Will Ashes or Body be Present
Place of Internment

Place of Internment St. Andrew's Memorial Garden Other Other
Name on Plaque Name on Plaque First Last
If interned in St. Andrew's Memorial Garden
Approximate # of people attending
Would you like an organist?

$300 fee, extra for soloist
Would you like flowers ordered for the Altar?

We will use a Boca Grande florist
Scripture Readings

See website for suggestions
Holy Communion?
Chalice Bearers?
Lay Readers?
Family Member Involvement

Family Member Involvement Holy Communion Chalice Bearer(s) Lay Readers None

Do you want family involved? Please check all that apply.
Family Rememberances
Family Speakers
Will you have a reception?

Will you have a reception? Yes No
If so, where will the reception be held?
Funeral Director
Funeral Director's hone number Funeral Director's hone number - ### - ### ####
Funeral Director's Address Funeral Director's Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country