EmailMe Form - Funeral Director Information Worksheet

Funeral Director Information Worksheet

OUR LADY OF THE LAKES PARISH
527 Bairdford Road, P.O. Box 149
Bairdford, PA 15006

Phone: 724-265-2070
Fax: 724-265-6316

Funeral Directors are asked to submit the following information
AT LEAST 48 HOURS PRIOR TO the date of any services.

* * * * * FUNERAL DIRECTORS ~ PLEASE TAKE NOTE * * * * *

You MUST contact the Pastor and obtain his approval for the date, time, and location of the funeral BEFORE finalizing any arrangements with the family. All contact information must be included on this form before submitting it to the parish office.

This is necessary to prevent conflicting scheduling of funerals by different funeral homes on the same date.

Thank you for your cooperation.
Rev. James P. Holland, Pastor
Our Lady of the Lakes Parish

===== PASTOR'S APPROVAL OF REQUESTED DATE / TIME / LOCATION ====
Name of Funeral Director
or Funeral Home Employee Contact
filling out this form *
First Last
Phone Number of Funeral Director
or Funeral Home Employee Contact
filling out this form *
### - ### - ####
Pastor contacted on *
MM / DD / YYYY
Pastor contacted by *
First Last
Funeral date, time and location approved on *
MM / DD / YYYY
Funeral date, time, and location approved by *
First Last
=============== FUNERAL INFORMATION ==================
Today's Date *
MM / DD / YYYY
Name of Deceased *
First Middle Last
Age of Deceased
Date of Death
MM / DD / YYYY
Requested Funeral Date
MM / DD / YYYY
Nearest Relative or Contact Person
First Middle Last
Relationship to the Deceased
Contact Phone
### - ### - ####
Contact Information

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Funeral Home in charge of arrangements *
Days and Times of Visitation / Viewing / Other Information or Comments
Date and Time of Vigil Service at Funeral Home (if requested by family)
If Vigil Services are requested by the family, the parish office and parish Funeral Ministry are to coordinate in notifying the Rosary Society and Ladies of Charity.
Date and Time of Funeral Service at Church or Funeral Home *
MM / DD / YYYY HH : MM AM/PM
Funeral Service *
Funeral Mass at St. Victor Church of Our Lady of the Lakes Parish (Bairdford)
Funeral Mass at Transfiguration Church of Our Lady of the Lakes Parish (Russellton)
Blessing Service only at funeral home (priest required)
Blessing Service only at funeral Home by funeral director (no priest required)
Graveside Service only at cemetery (priest required)
Graveside Service only at cemetery by funeral director (no priest required)
Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at both)
Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at funeral home only)
Both blessing service at funeral home AND graveside service at cemetery (no church services; priest required at cemetery only)
When preparing the obituary, Funeral Directors are asked to please indicate in the funeral notice and obituary the name / location of the specific church at which the funeral Mass will be celebrated. Our Lady of the Lakes Parish consists of both St. Victor and Transfiguration Churches.
Disposition of Remains *
casket at church
cremains at church
memorial service only (no remains at church)
No services in church (see "Funeral Service" section above)
This information is REQUIRED in order for the sacristan and funeral ministry to properly prepare the church for any funeral services to be held there.
Cemetery or Mausoleum (for casket interment / entombment)
Cemetery or Columbarium (for cremains interment / inurnment)
Interment / Inurnment Information *
Immediately following funeral service -- request priest to attend
Immediately following funeral service -- priest does not need to attend
private, at the convenience of the family
Is the Parish Center Activity Building needed for a post-funeral meal? *
Yes
No
If the use of the parish activity building for a post-funeral meal is requested by the family, the parish office and parish Funeral Ministry are to coordinate in making any necessary arrangements.
============= FOR PARISH OFFICE USE ONLY ================
Recorded in Sacramental Register
MM / DD / YYYY
Parish Bulletin / Lector Sheet
MM / DD / YYYY
Music Ministry Options (indicate all that apply)
Organist
Resurrection Choir / Cantor
No Music
If the use of the Music Ministry is required, the parish office and parish Funeral Ministry are to coordinate in notifying the appropriate person(s).

===== PASTOR'S APPROVAL OF REQUESTED DATE / TIME / LOCATION ====

=============== FUNERAL INFORMATION ==================

============= FOR PARISH OFFICE USE ONLY ================