Christian Funeral Advance Planning Form Emmaus Lutheran Church, Wauseon, Oh (Page 3 of 3) in pdf

Christian Funeral Advance Planning Form Emmaus Lutheran Church, Wauseon, Oh Page 3

6. My Funeral Home of preference is ____________________________________________________

Funeral Home phone number

____________________________________________________

Flowers

Yes/No

Visitation prior to service

Yes/No

I desire memorials be given to ____________________________________________________

7. Name of the cemetery where you wish to be buried _______________________________________

8. Are you eligible for military honors?

Yes/No

9. I desire a luncheon in connection with the Service

Yes/No

After the committal

Yes/No

Immediately after the Service

Yes/No

(e,g,, when committal will take place

somewhere quite distant from the place of

the service.)

10. Names of Pallbearers

_________________________________________________________________

11. Important persons to be notified immediately of my death*

Name _______________________________________

Phone # _______________________

Name _______________________________________

Phone # _______________________

Name _______________________________________

Phone # _______________________

Name _______________________________________

Phone # _______________________

12. Any other special requests or instructions?

With this information I recommit myself to God’s grace and care for me in Jesus Christ.

Signed: Name ___________________________________________

Date: ___________________

*Please give copies of this form to all the persons mentioned in #11 and to the church office.

Christian Funeral Advance Planning Form Emmaus Lutheran Church, Wauseon, Oh Page 3