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Funeral Program Questionnaire
Please provide information accurately. You may email any additional information to Jayda at Jaydar100@gmail.com. For any additional questions, call Jayda at 727-344-9749.
Family Contact Person's Name
*
First Name
Last Name
Family Contact Person's Phone Number
*
-
Area Code
Phone Number
Family Contact Person's Email
*
example@example.com
Style or Design of Program (i.e. Bi-fold, Trifold, Gatefold, or Booklet):
If this is a Bi-fold program, how many pages (including the front and back covers) do you want?
4 pages (Bi-fold program)
8 pages
12 pages
16 pages
20 pages
How many programs do you want to purchase?
Check out our CW Hex Color PDF to help you with color options.
Which colors would you like as the main theme for your program?
You can name colors or use the Hex Color Numbers listed in the PDF above.
What type of graphics would you like included?(Ex: clouds, doves, flowers, both flowers and clouds, Victorian pattern, sports theme, basketball, football, etc.)
Do you need Wake Programs?
Yes (contact Jayda for pricing)
No
Do you need Thank You Cards?
Yes (contact Jayda for pricing)
No
List the page order here:
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Front Cover
Choose one or Provide your own
In Loving Memory of
Memorial Service For
Celebration of Life For
Celebrating the Life of
Other
Name of the deceased as you want it to appear on the program.
*
Date of Birth
*
-
Month
-
Day
Year
Date
Date of Passing
*
-
Month
-
Day
Year
Date
Date of Service
*
-
Month
-
Day
Year
Date
Time of Service
*
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 Service
Location of Service Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Officiant with Title:
Name of Pastor of the church, if different from Officiant:
Name and title of person delivering Words of Comfort (aka Eulogy):
Other name and title if needed on the front cover:
Upload cover photo. Please use original pictures as cell phone screen shots do not print well. If you need pictures scanned, please contact Jayda ASAP at (727) 344-9749 to arrange this service.
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OBITUARY
Type the Life Story/ Reflection of your loved one or upload the MSWord file below:
Upload Life Story/ Obituary File
Do you want to add "preceded in death" at the end of the obituary?
Yes
No
If yes, type the names and relation here if it is not already included on the Life Reflection
Left to cherish his/her memory are (list family members), if you did not include them on the bottom of the Life Reflection:
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PROGRAM-ORDER OF SERVICE
Please enter the program order or upload it below, with the names of each participant and church name if applicable. You may use the sample program BELOW as a guide. Thank you.
Upload typed program in MS Word or a similar program.
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Scripture and/ or Poem
As you finalize your funeral program, you may want to include a poem or scripture, especially for a trifold program layout. Please type or upload a Bible verse or poem you'd like to include here.
Type the Bible Scripture or poem here.
Upload a file or picture of a Bible Scripture or poem here.
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Pallbearers
Usually about 6 people
Flower Attendants
Acknowledgments (Leave blank if you want us to provide)
Interment Location (If applicable)
Name and address of Cemetery
Repast (If applicable)
Place and Address
Final Arrangements Entrusted To
Name and address of Funeral Home/ Crematorium responsible for arrangements
Upload any photos you want in the program. If it is more than 15, email them to jaydar100@gmail.com. Be aware of screenshots of photos or photos of photos taken with a cell phone, as they often do not print well unless taken with a newer phone and at the highest quality. If you need photos scanned and do not have a high quality scanner, please contact Jayda ASAP to complete this. Consent to Use Photos in Funeral Program: By providing your photos, you are giving permission for them to be used in the funeral program and related materials.
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