Funeral Service Request Form
Decedent's Name
*
Decedent is WABC Member:
*
Please Select
Yes
No
Wheeler Avenue Baptist Church does not perform the funeral services of nonmembers. This includes members' loved ones who are not members.
Date of Death
*
-
Month
-
Day
Year
Date
Requested funeral service date:
*
-
Month
-
Day
Year
Service date/time is contingent upon Church availability and should not be scheduled without consulting with the Minister of Congregational Care. Typically, services are scheduled on Tuesdays, Thursdays, and some Saturdays, depending on campus availability.
Funeral Home Name:
*
Funeral Home Location (city AND state)
*
Special instructions/details:
Requester's Name
*
Requester's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Requester's Email
*
example@example.com
Requester's relationship to the deceased:
*
Please Select
Spouse
Parent
Sibling
Child
Grandparent
Other
If “Other” selected, please share who:
*
Please verify that you are human
*
Submit
Should be Empty: