Funeral Date
-
Month
-
Day
Year
Date
Start Time
Funeral Home
Booking Person:
Please Select
Doug
Marcy
David
Elizabeth
Jim
Nathan
Other
(Person Submitting Form)
Service Director:
Please Select
Doug
Marcy
David
Elizabeth
Jim
Nathan
Other
(Director For This Service)
Service Director Cell/Text
Contact E-Mail
Deceased Full Name
Add Obit pic as thumbnail?
Yes, from Obituary
Yes, use photo attached below
No, plain is fine
Attach Photo for thumbnail
Browse Files
Cancel
of
Live Streaming?
Yes, Live Streaming (Video Recording Included)
No, Video Recording Only
Live Stream Link?
Dedicated Link
harborview.live
Both of Above
Streaming Package (Click all that apply)
Single Location ($700, includes up to 2 hours of live streaming)
Two Locations ($900
, includes up to 3 hours of live streaming)
SMP Chapel with Graveside ($700)
Single Location Additional Hours (Add $200 per each additional hour)
Total Streaming Hours Needed
Single Location
SMP Chapel Only
SMP Graveside ONLY
SMP Chapel AND Graveside (Add $100)
Funeral Home
House of Worship
Cemetery
Other
Live Streaming is:
Indoor Only
Outdoor Only
Both Indoors & Outdoors
Outdoor Audio:
Yes, please attach your camera mic to OUR lectern.
Yes, please bring YOUR lectern for your camera mic.
No, none of above needed.
Other
Funeral Home Name & Address
Church Name & Address
Cemetery Name & Address
Grave Location at Cemetery
Other Name & Address
Second Location
Funeral Home
Church
Cemetery
Other
Funeral Home Name & Address
Church Name & Address
Cemetery Name & Address
Grave Location at Cemetery
Other Name & Address
For Cemetery Only Services:
Start Streaming with Hearse Arrival
Start Streaming with Carrying Casket
Start Streaming with Family Walking To Graveside
Start Streaming with Guests In Place, Start of Service
Other
Would You Like Video Copy on USB?
Yes, please mail to Brezniak Funeral Directors
Yes, please mail direct to family
Please send download link after service.
None of the above needed
Full Mailing Name & Address for USB
Payment Via:
Funeral Home will bring check
Online Payment Below
Other
Online Payment
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( X )
Single Location
$600.00
$
600.00
Two Location
$800.00
$
800.00
SMP Chapel & Graveside
$700.00
$
700.00
Total
$0.00
$
0.00
Credit Card
Anything else? (Orthodox? Special Events? Etc?)
Submit
Should be Empty: