Burial form

Burial form

We are deeply sorry for the loss of your precious child
Are you a member of the New Rockford community?*

YesNo
Parent of deceased child*

First NameLast Name
Parent of deceased child

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
How do you prefer to be contacted?*

EmailPhone callTxt message
Name for your child's stone marker (Line 1)
example: Lily Jean Steele, Baby Steele, Baby Girl
Date for your child's stone marker (Line 2)
example: June 14th, 2019
If you would rather not use a name and date on your baby's burial marker, you may enter in the lines above what you would like written to remember your baby. Note: After submission, it must be approved by Lily's Hope Ministry.

Examples (but not limited to):

Line 1: Our dear child

Line 2: You will be missed
Line 1: Precious Baby Boy

Line 2: Never Forgotten 2019
Line 1: Sweet Daughter

Line 2: Forever Loved 2019
Age of baby at death (Information used for casket size)

> 12 weeks12-19 weeks20-30 weeksFull term
If you would like to have a memorial service, funeral or burial service with a clergy member, please contact your priest or pastor. If you do not have a christian minister that you are affliated with, but would like to contact one; Pastor Mindy Meier can be reached at 701-625-1544. If you would like assistance with this Lily's Hope desires to assist you.

Evans Funeral Home will prepare the burial area for your child, if you would like to have them present at the time you bring your baby to his/her final resting place, they are happy to be there. Please contact them to let them know of the death of your child, what your wishes are and to coordinate a time and date if applicable. This is all done at no additional cost to you.

Depending on the time of year, you may need to store the remains of your baby until the weather premits burial. Please don't hesitate to contact us for assistance with this.

If you have questions regarding any of the above information, please do not hesitate to contact Lily's Hope Ministry.
I am able and would like to contribute the $50 suggested donation*

YesNo
Please mail the $50 suggested donation to Lily's Hope Ministry or donate online: www.lilyshopeministry.com
Lily's Hope Ministry

1750 67th Ave NE

New Rockford, ND 58356
All checks are made payable to: Lily's Hope Ministry
I have read and understand the above information.*

Yes
All information is for Lily's Hope Ministry only, it is confidental and will not be shared.
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