Submission form

The passing of a loved one can be a difficult time for all involved. To help make things easier please fill out the form below with contact information and a few details about your loved one and his/her passing. A church representative will contact you shortly to collect complete information and help you to organize any funeral or memorial services if needed.

Your Name*
First Last
Your Phone*
Address*
Street Address City State ZIP Code
Your Email*
Deceased Information
Name of deceased*
First Last
Date the deceased passed*
MM slash DD slash YYYY
Desired date for funeral/memorial
MM slash DD slash YYYY
Details & comments*

Submission form

Deceased Information