Funeral Form

St. Ann Funeral Form

Date & Time of Mass will be confirmed by our office once the form is submitted.
Full Name of Deceased:

First NameMiddle NameLast Name
Address of Deceased:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Date of Death:

MonthDayYear
Date
What Catholic Sacraments were received by the deceased? (Select all that apply)
Body or Cremation?
Please provide the names of surviving immediate family & relationship to deceased:
What date and time would you like for the Mass? (Mass usually begins at 10am)

MonthDayYear
Date
Hour MinutesAM/PM Option
Any other specific date and time, if the above selection is not possible.

MonthDayYear
Date
Hour MinutesAM/PM Option
Would you like our Bereavement Committee to pray a Rosary before Mass? (it would begin 30 minutes before the start of Mass)
Please list any hymn requests you may have for the Mass:
(Ave Maria, On Eagles Wings, Here I Am Lord, Amazing Grace, etc...)
Readings for the Funeral Mass:
Readings:
These must be readings specific to the funeral liturgy.
Do you have family members (2) who would like to read the readings and prayers?
Date of Burial:

MonthDayYear
Date
Place of Burial:
Name of Cemetery (even for cremation, the ashes MUST be buried or placed in a columbarium).
Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Would you like a meal, provided by our Bereavement Committee, in the Parish Hall? (this would follow the Graveside, if the Bereavement Committee is available)
How many people would be attending the meal?
Do you have a slide show that you would like projected on the screen during the meal (you are responsible for providing the slideshow via USB)?
Would you like a microphone available for people to share memories or a eulogy during the meal? (eulogies are not permitted during the Mass)
Relative's Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Funeral Home
Name of Funeral Home (Laurel Land, Lucas, Greenwood, etc.)
Funeral Home Contact Name

First NameLast Name
Funeral Home Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any questions? Please ask in the space below or feel free to call us:
If you chose to have a Rosary before Mass, please upload a picture you would like used on the Rosary pamphlet:

Cancelof
Should be Empty:

St. Ann Funeral Form