Funeral Director: Funeral Request &amp; Data Form

Funeral directors: To request a funeral Mass date and time, please submit the below form as soon as possible. To receive immediate attention, you may follow up with a phone call, to inform us of your request, which will be processed shortly after submittal. Once a date and time are booked, a confirmation email will be sent to you as soon as possible.

Our office hours are 9:00am to 1:00pm daily, Monday through Friday. For requests submitted outside of these hours, please contact the Pastor after completing this form.

If the funeral director identifies particular personal information that would be helpful to the priest who will be visiting with the family at the funeral home or presiding at the Funeral Mass, please fill out and submit the Funeral Director: Additional Information Form as soon as possible. Please note: this form will only be shared with the appropriate clergy. If the family requested an outside clergy member for the funeral, please provide the name and contact information so that we may forward to the appropriate person.

Once the family has decided on the Funeral Mass preparations, the funeral home should forward that information using the Funeral Director: Funeral Mass Form. Please submit that form by 3:00pm on the day before the Funeral Mass.

Deceased Full Name REQUIRED Please fill out this field. Please enter valid data.

Deceased Street Address REQUIRED Please fill out this field. Please enter valid data.

Deceased Street Address 2 Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Church of Funeral Mass REQUIRED Please fill out this field.

Requested Date of Funeral Mass (Please list 3 options) REQUIRED Please fill out this field. Please enter a date.

Requested Time of Funeral Mass (Please note our funerals take place at 10:30am). REQUIRED Please fill out this field. Please enter valid data.

Does the family want music for the Funeral Mass? REQUIRED Yes No Please fill out this field.

Due to technical difficulties, we cannot offer live streaming of the mass at this time.

Deceased Place of Birth REQUIRED Please fill out this field. Please enter valid data.

Deceased Date of Birth REQUIRED Please fill out this field. Please enter a date.

Deceased Date of Death REQUIRED Please fill out this field. Please enter a date.

Deceased Age at Death REQUIRED Please fill out this field. Please enter valid data.

Next of Kin

Other Cemetery - Name and Town Please enter valid data.