Submitted by
Email
Full Name of Deceased
*
First Name
Middle Name
Last Name
Burial Service Only?
*
yes
no
Type of Mass?
*
Funeral Mass
Memorial Mass
Other
Date of Mass
-
Month
-
Day
Year
Day of the Week
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Time of Mass
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of Mass
SFX Church
Ignatius Chapel
Other
Presider
Fr. Eddie Ngo, SJ
Fr. Bob Fambrini, SJ
Fr. Chuck Tilley, SJ
Dcn. Tom Klein
Dcn. Jaime Garcia
Other
About the Deceased
Deceased Date of Birth
*
-
Month
-
Day
Year
Date of Death
*
-
Month
-
Day
Year
Place of Death (City/Town)
*
Age at Death
*
Address at Time of Death
*
City, State, Zip Code
Name of Next of Kin
*
First Name
Last Name
Relationship to Deceased
*
Next of Kin Relationship to Deceased
Child
Sibling
Spouse
Friend of the Family
Other
Family Contact
*
First Name
Last Name
Family Contact Relationship to Deceased
Child
Sibling
Spouse
Friend of the Family
Other
Phone Number of Family Contact
*
Registered Parishioner?
*
yes
no
Other
Funeral Arrangements
Funeral Home/Mortuary Name
*
Funeral Home Contact
*
First Name
Last Name
Phone Number
*
Visitation?
*
yes
no
Date of Visitation
-
Month
-
Day
Year
Date
Day of the Week of the Visitation
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Hours of the Visitation (Start and End Time)
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Location of Visitation
Mortuary
SFX Church
Ignatius Chapel
Priest requested for Rosary/Vigil Service?
yes
no
Other
Estimated Attendance (Number of Persons)
*
For Maintenance: Type of Mass
*
Mass with casket/body
Mass with cremains
Memorial Mass without Casket or Urn
Other
Burial immediately following Mass?
*
yes
no
Other
If Burial immediately follows Mass, is the Priest requested for Burial Service?
yes
no
Other
Cemetery Name
*
Address of Cemetery
Submit
Should be Empty: