Point of Contact Name *

First Name

Last Name

Best Number to Reach You

(###)

###

####

Deceased's Name *

First Name

Last Name

Is the Funeral or Memorial service at NBCOC? *

Yes

No

Funeral Date

MM

DD

YYYY

Time

Hour

Minute

Second

AM PM

If the service is at the church building, will there be special music or songs played over the sound system? *

All digital songs to be used during the service at NBCOC must be submitted at least 24 hours before the funeral date and scheduled time. It MUST be in mp3 format.

Yes

No

Do you need us to arrange a meal for the family on the day of the funeral?

Yes

No

If the family needs a meal, do you want the meal before the service or after the service?

Before

After

Who will design and arrange the funeral service handout? *

If the church is to design and print the handout, we will need all information submitted no later than at least 24 hours before the funeral date and scheduled time.

A family member or friend

The funeral home

We need the church to help produce the handout

Will the family need to produce a video? *

If the church is to produce the video, we will need all pictures and music submitted no later than at least 24 hours before the funeral date and scheduled time. The target length of the video is 5 minutes and it MUST be in mp4, MOV or mpeg format.

Yes, a family member or friend will produce the video

No, the funeral home will produce the video

Yes, but we need the church to help us with producing the video