Funeral Liturgy Selection Form

Name of Deceased (Required)*

First NameLast Name

Date of Birth:*

Date of Death and Age:*

Name of Funeral Home Handling the Arrangements:

Funeral Date (Required)*

Date

Start Time (Required) *

Hour Minutes

AM/PM Option

Will there be a Visitation?*

YesNo

If yes, Visitation Date (Required)

Date

If yes, location of Visitation (Required)

If yes, Visitation Start Time (Required)

Hour Minutes

AM/PM Option

Burial Date (Required)*

Location of Burial Location (Required)

Burial Start Time (Required)

Hour Minutes

AM/PM Option

Do you request the presence of a Deacon or Priest at the Burial?

YesNo

Name of Family Contact (Required)*

First NameLast Name

Relationship to Deceased*

Email of Family Contact (Required)*

example@example.com

Phone Number of Family Contact (Required)*

Please enter a valid phone number.

Please indicate which will be present in the church (Required)*

CasketUrnNeither

Processional Hymn (Required)*

First Reading (Required)*

Name of Reader for First Reading (Required)*

Type "priest" if you do not have a reader. The reader must be a practicing Catholic.

Responsorial Psalm (Required)*

Second Reading (Required)*

Name of Reader for Second Reading (Required)*

Type "priest" if you do not have a reader. The reader must be a practicing Catholic.

Gospel Reading (Required)*

General Intercessions/Prayers of the Faithful (Required)*

Version 1Version 2

Name of Reader for General Intercessions/Prayers of the Faithful (Required)*

Please type "priest" if you do not have a reader. This reader does not have to be Catholic, but must be Christian.

If desired, please indicate any names of deceased relatives to pray for by name in #3 of the intercessions:

Offertory Hymn (Required)*

Name of Gift Bearers (Required)*

You may choose up to 4 gift bearers. Please type "None" if you do not have any. Gift bearers must be practicing Catholics.

Communion Hymn (Required)*

Recessional Hymn (Required)*

Estimated Number of People in Attendance (Required):*

Would you like us to publish the Visitation/Funeral/Burial details on Flocknote, our email communication platform, for any parishioners who might like to attend?*

Yes, please publish the details on FlocknoteNo, please do not publish on FlocknotePlease publish some but not all of the details on Flocknote

If you would like us to publish some, but not all of the details on Flocknote please specify which services/liturgies below:

Please upload a photo of the decedent for use on the Worship Aid and the obituary if possible.

Additional Comments (and link to the obituary if you were unable to upload it above: