My Funeral

1

My name:included a nickname if applicable

First Name

Middle Name

Last Name

Suffix

2

Email

example@example.com

3

Please help honor my wish to have my body:Select only one

Embalmed and buried in a casket (list any clothing/item specifications in "other" field of this question)

Embalmed (for open-casket viewing/time) and then cremated (list any clothing/item specifications in "other" field of this question)

Cremated by flame (combustion cremation) (list anything you'd like included with you, including preferred clothing if applicable)

Cremated by water (alkaline hydrolysis/aquamation)

Buried (full-body) without embalming (green/eco)

Other

4

Do you wish to have your organs donated if possible?If you only want certain organs considered, or if you are pre-registered to donate your body to science, please select YES and elaborate later in the questionnaire.

YESNO

5

I would like my remains:Choose an option and provide additional details in the last box

Buried in a plot at a particular location (please provide details and include the name of the location/cemetery, any clothing you'd prefer to wear, and anything you'd like included in your casket)

Interned In a mausoleum (please provide details and include the name of the location/cemetery)

Set in an urn (please provide details if already purchased/chosen, including where you’d prefer the urn to reside)

Scattered at a particular location (please provide details and include the name of the location)

Allocated to my family and friends (please elaborate)

Other (please provide particular details below)

I have already made arrangements to donate my body to an organization (please list details below):

Other

6

Place of restIf you would like a tombstone or memorial plaque placed in your honor, please include its information here:

7

Place of rest:If you would like a tombstone or memorial plaque placed in your honor, please include its information here:

I would like the following information on my grave marker/tombstone/plaque:

Are you eligable for military honors?

Include this quote/scripture/etc.

Location preference of marker/tombstone

Type of tombstone/marker/plaque

8

If possible, please try to remember me through a:Select your preference(s); include additional details in final box of this question

Funeral

Memorial Service

Celebration of Life

Small graveside service

Living Funeral/Eulogy exchange in my presence before my passing

Other (please provide particular details below)

Other

9

Do you have a particular organization in mind for memorial gifts in your honor?Enter any instructions here:

10

During my service, I also appreciate the chance for my loved ones to remember/honor me through (select all that apply):Select your preference(s); include additional details in final box of this question

A wake/visitation

Viewing of body/open-casket

Presence of my cremains

A meal before/after the service (please elaborate in the last box of this question)

A community activity, such as release or dedication (please specify in the last box of this question)

Other (please specify in next box)

Other

11

In particular, I'd love (select any that apply):Select your preference(s); include additional details in final box of this question

For guests to bring food to enjoy after the service (specify if there is a particular type in mind, such as a dessert potluck or a potato bar, etc).

A catered or potluck meal after the service

For guests to wear a particular type of clothing to the service (such as a sports team - please specify)

For the service to be thematic (such as Star Wars or a hobby - please specify!)

For certain following music to be played before/after the ceremony (list in final option below)

A fundraiser in my memory in lieu of a service (please explain)

Other (list below)

Other

12

If the venue of the service allows, I’d also love the following included:Select your preference(s); include additional details in final box of this question

A memory table with photos on display

A guest book (list benefactors below)

A “memory favor” for service guests (such as a memorial rock - please specify)

A photo slide show (if particular photos are to be included, please specify)

Digital space for memorialization (please specify)

Other (please specify)

Other

13

In terms of music at my service, I'd preferSelect all that apply

14

Please list here any song/musician/instrument preferencesthere will be an option to choose from a pre-selected list of hymns if needed in the next question

15

Please list here any song/musician/instrument preferencesthere will be an option to choose from a pre-selected list of hymns if needed in the next question

16

Popular Hymn OptionsThese are only suggestions based on popularity with corresponding ELW hymnal numbers in parenthesis. If you'd like to include something that is not on the list, please indicate its information during the next question.

17

Service ParticipantsHere is a chance to assign certain people to play a designated part in your service.

Clergy member name, contact information:

Preferred venue/church:

Reader names:

Usher/pallbearer name(s):

Musician names:

Additional participant name(s) and role:

18

Readings/ScripturesMost services include scripture that's important to the deceased and/or their loved ones. You may fill-in your own choices below, or choose from the lists in the next few questions.

Clergy member name, contact information:

Reader names:

Musician names:

19

Service ParticipantsHere is a chance to assign certain people to play a designated part in your service.

20

Readings/ScriptureMost services include scripture that's important to the deceased and/or their loved ones. You may fill-in your own choices below, or choose from the lists in the next few questions.

21

Popular FIRST READING OptionsThese are only suggestions based on popularity. If you'd like to include something that is not on the list, please indicate its information in question 15.

22

Popular PSALM OptionsThese are only suggestions based on popularity. If you'd like to include something that is not on the list, please indicate its information in question 15.

23

Popular SECOND READING OptionsThese are only suggestions based on popularity. If you'd like to include something that is not on the list, please indicate its information in question 15.

24

Popular GOSPEL READING OptionsThese are only suggestions based on popularity. If you'd like to include something that is not on the list, please indicate its information in question 15.

25

My OriginsEnter as much or as little information as you'd like about your origins - hometown, parents, childhood, etc.

Name (given, nickname)

Date of Birth

Place of Birth/Hometown

Parents/Siblings/Family

Marriage spouse(s) and date(s), if applicable

Children/additional Family members

Optional: write a few sentences about your birth, upbringing, family, etc.

26

My ExperienceEnter as much or as little information as you'd like

School(s) attended and degrees earned

Occupational history, career highlights, etc.

Military Service & Rank – Branch of military, wars served in, rank attained, special distinctions and awards

Memberships, volunteerism, church affiliation, etc.

Optional: In one line, how did you make the world a better place? The more concise, the better.

27

My interestsList any meaningful places you’ve visited, sports you’ve played, activities you enjoy participating in, things you like to collect, favorite movies and books, etc. You can include uploaded photos or website links.

28

My specific quality I'd like others to remember: blank
My favorite catch-phrase is: blank
A favorite memory of mine is:
My favorite quote/song/book, etc

29

Upload any relevant files hereIf you have already written an obituary or have a contract with a funeral home, you may include it here

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

30

Do you have a photo you'd like used in your remembrance?You may upload it here.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

31

Additional thoughtsif non, skip to next question

32

I would like (person) to have a copy and utilize my answers to this questionnaire when the time comes Email .
Please also provide a copy to: (clergy/pastor, etc.) Email .

33

By writing your signature here, you give permission for Martin Luther Lutheran Church to access your submissions and use them along with your next-of-in in your end-of-life planning planning.