Memorial / Funeral Service Request Form
At Eastmont we realize that the passing of a loved one ushers in a time grief and sadness. So itis our desire to come alongside you and your family during this time to be a comfort and to prayfor the Lord’s peace and compassion to be upon you. The Word of the Lord is true and in Jesus’own words, “Blessed are those who mourn, for they shall be comforted.” (Matthew 5:4)
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of loved one who has passed away
First Name
Last Name
Your relationship to the deceased:
Do you have a desired date for the Service?
Yes
Unknown at this time
Date of Service desired
-
Month
-
Day
Year
Date
Any other information you would like to share at this time?
Submit
Should be Empty: