Full Name of Deceased REQUIRED Please fill out this field. Please enter valid data.

Age REQUIRED Please fill out this field. Please enter valid data.

Date of Death REQUIRED Please fill out this field. Please enter a date.

Address of Deceased REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Spouse's Name Please enter valid data.

Name(s) of Son(s) Please enter valid data.

Name(s) of Daughter(s) Please enter valid data.

Name(s) of Grandchild(ren) Please enter valid data.

Name of Contact Person REQUIRED Please fill out this field. Please enter valid data.

Phone Number of Contact Person REQUIRED

Please fill out this field. Please enter a phone number.

Email of Contact Person Please enter an email address.

Address of Contact Person REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Funeral Home Name REQUIRED Please fill out this field. Please enter valid data.

Phone Number of Funeral Home REQUIRED

Please fill out this field. Please enter a phone number.

Visitation Date REQUIRED Please fill out this field. Please enter a date.

Time of Visitation REQUIRED Please fill out this field. Please enter valid data.

Funeral Service Location REQUIRED Please fill out this field. Please enter valid data.

Funeral Service Date REQUIRED Please fill out this field. Please enter a date.

Time REQUIRED Please fill out this field. Please enter valid data.

Celebrant REQUIRED Please fill out this field. Please enter valid data.

Type of Service REQUIRED Mass Word Service Please fill out this field.

Place of Burial REQUIRED Please fill out this field. Please enter valid data.

Would a Family Member or Friend Like to Deliver a “Words of Remembrance”? REQUIRED Yes No Please fill out this field.

Please read and follow the “Words of Remembrance” guidelines found on the main funeral page of our website.

A Eulogy is Not Permitted.

Speaker's Name Please enter valid data.

Speaker's Phone Number

Please enter a phone number.

Introductory Rite

Entrance Song REQUIRED Please fill out this field. Please enter valid data.

Placing of Pall REQUIRED Funeral Home Family Members Please fill out this field.

If selected "family members" above, please type names below (4 Names) Please enter valid data.

Placing of Christian Symbol (ex: cross) REQUIRED Priest Family Member Please fill out this field.

If selected "family member" above, please type name below (1) Please enter valid data.

Liturgy of the Word

First Reading Passage REQUIRED Please fill out this field. Please enter valid data.

Name of First Reader REQUIRED Please fill out this field. Please enter valid data.

Responsorial Psalm Passage REQUIRED Please fill out this field. Please enter valid data.

Responsorial Psalm Sung Recited

Name of Reciter/ Singer of Psalm REQUIRED Please fill out this field. Please enter valid data.

Second Reading Passage REQUIRED Please fill out this field. Please enter valid data.

Name of Second Reader REQUIRED Please fill out this field. Please enter valid data.

GOSPEL
THE PRESIDER WILL CHOOSE THE GOSPEL

Homily

(PLEASE INDICATE ANY INFORMATION THAT MIGHT BE HELPFUL TO THE HOMILIST)

Deceased was REQUIRED Married Widowed Single Please fill out this field.

Number of Children REQUIRED Please fill out this field. Please enter valid data.

Number of Grandchildren REQUIRED Please fill out this field. Please enter valid data.

Active Member of the Parish? REQUIRED Yes No Please fill out this field.

Special Comments About the Deceased REQUIRED Please fill out this field.

General Intercessions (will be read by priest) Please enter valid data.

Liturgy of the Eucharist

Presentation of Gifts by: REQUIRED Please fill out this field. Please enter valid data.

Song for the Presentation of the Gifts REQUIRED Please fill out this field. Please enter valid data.

SANCTUS: (SHOULD ALWAYS BE SUNG)
DOXOLOGY: (SHOULD ALWAYS BE SUNG)
GREAT AMEN: (SUNG IF DOXOLOGY IS SUNG)

Our Father REQUIRED Sung Recited Please fill out this field.

LAMB OF GOD: (SHOULD ALWAYS BE SUNG)

COMMUNION OF RITE: COMMUNION WILL ONLY BE GIVEN UNDER ONE SPECIES

Communion Song REQUIRED Please fill out this field. Please enter valid data.

Meditation Song (if none is desired, please type "none" in space provided) REQUIRED Please fill out this field. Please enter valid data.

Additional Comments

Funeral Liturgy Guide

Online Form Option

Introductory Rite

Liturgy of the Word

Homily

Liturgy of the Eucharist

Printable Form Option