Personalized Touch Funeral Program Questionnaire

Personalized Touch

Personalized with Your Special Touch
Virtual Obituary Service Form

Please complete form below and answer all that apply.
Name of Deceased

PrefixFirst NameMiddle NameLast NameSuffix
Date of Birth

MonthDayYear
Date
Date of Passing

MonthDayYear
Date
Location of Service

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Service

MonthDayYear
Date
Time of Service

:HourMinutesAM/PM Option
Choose one or Provide your own

In Loving Memory ofHeaven Opened It's Gates ForCelebration of Life ForCelebrating the Life ofOther
Name of Officiant (Pastor)

First NameLast Name

Life Story of your loved one
Do you have images of your loved one or video footage that you would like to include in the virtual obituary? Upload your images and videos below. Please make shure your images and video have a name.
Do you have images?
Upload your images below.
Do you have video footage?

YesNo
Upload File

Active Pallbearers/Honorary Pallbearers
6 Active and 6 Honorary
Final Arrangements Entrusted To
Name and address of Funeral Home/ Crematorium responsible for arrangements
Acknowledgments (Leave blank if you want us to provide)
Thank You for submitting your information to Buttafleye Ministry Obituary service. You will be contacted by one of our representatives. Please feel free to attend our Grief Ministry, if needed. Buttafleye Ministry " Prayer Warriors" are also avaible for prayer, anytime you need us. Visit our memorial and leave a comment. You are free to give and volunteer at any time. Click the button at the top of the page on our website. We want to hear from you, contact us at any time. Tell a friend.

Buttafleye Ministry

buttafleyeministry@gamil.com

Buttafleyeministry.org

512-553-1768
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Personalized Touch