Family Church History Forms Page 5
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5Family Member Name: _________________________
PERSONAL NOTES
Who would you like Christ Church to notify in case of an emergency?
Name
Phone
Relationship to you
_________________________________________________
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)
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________________
_________________________________________________
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_________________________________________________
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________________
If you have made funeral arrangements and would like to inform the church office of your wishes, please complete
the following:
Funeral Service Hymns:
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Funeral Service Scripture
(Book Chapter: verse):
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Funeral Service preference (please check):
Rite I________
Rite II________
Incense?________
Funeral Director/
Professional to Contact:
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Phone: (_______)________-__________
Place of Interment: If you wish to have your ashes interred in the Christ Church Memorial Garden check here
Otherwise, please enter
Name of Cemetery/
Place of Burial:
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Street:
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Borough/Township/City:
|______________________________| State: |_______|
ZIP Code: |______________|
THANK YOU...
... for taking the time to complete this survey. This information is vital in our efforts to increase the accuracy and completeness of
church records, and will be invaluable to the leadership of Christ Church as they try to do a better job of carrying out our mission
to you and to the community. FINALLY ..... If there is anything else about you that you would like to be included in church rec-
ords, or that others in the church might like to know about you, that we have not covered in any of the questions above, please
take a minute to include this information on a separate sheet of paper.
Revised: June 2005
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