UNITARIAN UNIVERSALISTS OF SAN MATEO Memorial Wishes Plan

Memorial Wishes Plan

UNITARIAN UNIVERSALISTS OF SAN MATEO
Unitarian Universalism honors each life as precious and unique, emphasizing the way we live rather than the specifics of our beliefs. Memorial and Celebration of Life services are an opportunity to lift up the values and life choices of the individual, providing comfort and inspiration to those left behind.

You may have already been reflecting on your lived experiences and what you have found meaningful. You probably have things you hope to be remembered for. It’s a good idea to share those insights with your family members and your minister.

Spend some time with this form so that your wishes will be available when needed. Take as much space as you need for each answer. If you will be submitting a paper copy of this form, you can add documents and photos with explanations.

Electronic copies will be converted to paper copies and confidentially and securely filed in the church office with the minister. Electionic form submissions will be kept private and can be only accessed by the form creator/office administrator and the minister. You may want to give copies to those closest to you. Scroll to the last page to Print a copy, to Save a draft, or to Submit your completed form. Update this form at any time. Contact your minister or pastoral care team if you’d like to have a private talk. Thank you for your trust.
Name*

First NameLast Name
Middle Name (optional)
Date of Birth
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Signature

Clear
Date Date (updated)

Memorial Wishes Plan
Immediate Family Member(s) Significant Other(s), Relationship(s):
Name, Relationship, Phone/ Email
Name, Relationship, Phone/ Email
Name, Relationship, Phone/ Email
Name, Relationship, Phone/ Email
Name, Relationship, Phone/ Email
Funeral Arrangements
Cremation or Interment
Mortuary Name/Contact:
Do you have an end of life plan/advance directive? (Five Wishes forms are available in the church office.)

YesNo
Other relevant information:

Memorial Wishes Plan
Memorial or Celebration of Life Service Planning
Who the Minister should work with most closely in planning:
Who I want to have participate in the service:
Readings I want for the service:
Favorite prayers:
Music I want for the service:
Favorite symbols or images:
Favorite quotes:
Favorite flowers or colors:
Donations (in Lieu of Flowers) to:
What I really don’t want:
Any thing else?
Personal History
Date & place of birth:
Those I call family:
Education & profession:
Places I have lived:
Significant life events:
Friends, colleagues, beloved pets:
Organizations I’ve supported:
Anything else?

Memorial Wishes Plan
Religious Identity
Childhood religious affiliation (if any):
How/Why I came to Unitarian Universalism:
What I value most about Unitarian Universalism:
UU Congregations I’ve been connected to (preferably with dates):
My favorite UU volunteer activities:
The wisdom sources that most inspire me:
The UU Principles that have most informed my life:
Spiritual practices/disciplines I find meaningful:
Religious identity:
Theist, Atheist, Agnostic, Mystic, Humanist, Panentheist, Something Else?
Anything else?

Memorial Wishes Plan
Other Important Things About Me
People/places that inspire me and why:
Ideas that inspire me:
What I wish I’d done differently:
What I want people to know about me:
Gratitude I want to express:
My “happy place”:
Wisdom to pass along:
Should be Empty:

Memorial Wishes Plan

Immediate Family Member(s) Significant Other(s), Relationship(s):

Funeral Arrangements

Memorial or Celebration of Life Service Planning

Personal History

Religious Identity

Other Important Things About Me