Memorial Request Form
Requestor / Contact Person
*
Person(s) responsible for the event
Contact Person Email
*
example@example.com
Contact Person Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of the deceased
*
Requested service date/time frame
*
Memorial services may be scheduled on Mondays to Thursdays between 10:00 a.m. and 3:00 p.m. (No later than 3:00 pm to allow for clean-up)
Estimated number of guests
*
I am interested in:
*
Memorial Service
Reception
I would like the following CGCC pastor to preside over the service:
*
Joel Dombrow
Andrew Poe
Carman Hammond
Matt Sherman
No preference
I am using an outside pastor
I am currently working with a funeral home
*
Yes
No
Funeral Home Name & Contact Person
If applicable
I have read the Memorial Information Packet and agree to the terms
*
Anything else we should know?
Continue
Continue
Should be Empty: