Funeral Request Form
Heritage Baptist Church
1. General Information
Name of deceased
Name of family member making decisions
Family member contact number
Phone number
Format: (000) 000-0000.
Family member email address
example@example.com
Funeral home contact information (if applicable)
Name of funeral home
Phone number of funeral home
Date & time requested for service
Will there be a graveside service? If so, where and when will it be held?
Is a meal needed? If so, for how many?
What is the anticipated attendance for the funeral?
Officiants
Will a Heritage pastor be officiating? If so, who?
Please Select
Marty Brown
Jonathan Dirrim
Rocky Hails
Jim Jackson
Kicker Kositzky
Will any other staff members be needed on the platform? (Please list)
If a non-Heritage pastor is preferred, please provide their name and phone number
Name
Phone number
Musicians & Song Choice
Will people from Heritage be asked to help with the music? If so, who?
Musicians from Heritage
Will non-Heritage people be asked to help with the music? If so, who?
Name & Number
Name & Number
What songs will be used? (Please provide list) (Any recorded music should be in mp3 format)
Audio/Visual Needs
Will there be a slideshow/video? (All videos need to be in mp4 format)
Do you want the service to be live-streamed?
Will there be an open-mic?
Programs
Will the funeral home provide the programs?
If you want Heritage to provide programs, please list the pertinent information to be included in the program (obituary, birthday/date of passing, Scripture verses, etc.)
Support Staff Needed
Please check the support staff you will need
Sound / Projection ($100)
Video / Livestream ($100)
Ushers
Meal Service (if there is a meal)
Logistics
Will there be a body at the service?
Will flowers be delivered outside of normal business hours (Mon-Thurs, 9-5)?
What time will the family be arriving at the Heritage facility?
Hour Minutes
AM
PM
AM/PM Option
How many family members will be in attendance (for seating purposes)?
Will any equipment be needed (easels, tables, etc.)?
Will there be military honors or any other unique elements?
Submit
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