Selections Necessary for Memorial Service Arrangements:



Sample Local Church UCC Funeral Planning Form

One form per person, please, and return it to name of pastor here. All forms will be stored in the Pastor’s Office and can be updated at any time.

Name: _______________________________________ Phone: _________________________________

Address: ______________________________________ Email: _________________________________

Name of family member or friend with whom you have shared this plan: _________________________________

• What setting do you prefer for your memorial service? Examples include: the church, a funeral home (specify if you know), a cemetery or military base (specify if you know), a family location, etc.

• What hymns would you like? (Generally 2 or 3 hymns are sung, with additional music included in Prelude or Postlude.) Examples include: Bless Be the Tie that Binds, As Thou Wilt, This is My Father’s World, He Lives, Jesus Keep Me Near the Cross, Peace Perfect Peace, O For A Thousand Tongues, My Jesus, Amazing Grace, and It is Well with My Soul.

• Are there other musical selections you would like included?

• What scripture readings would you like? (Generally 2 or 3 passages are read.) Examples include:

Psalm 139, Psalm 23, 1 John 3:16-24, John 14, 1 Corinthians 13, 2 Timothy 4:6b-8, 1 Thessalonians 5:9-11, Psalm 121, Matthew 11:28-30, Psalm 46, or other scripture passages that have been meaningful to your faith journey.

• Are there additional readings, including poetry, that you would like shared?

• Who do you envision participating in the memorial service? Clergy, family, friends?

• Are there specific events about your life (accomplishments, associations, memories, etc.) that you would like to be shared?

• Have you made preparations with a funeral home for your burial arrangements? If so, which funeral home?

• Would you like to designate the church or another charitable organization to receive memorial gifts in lieu of flowers?

• Do you have any special requests or symbolic items that you would like included in the display area and service? Examples include: a solo sung by a family member or items such as an American flag, a special piece of jewelry, or photos of family members.

Please check here _________ if you would like a pastoral call regarding this form.

Please check here _________ if you would like information on how to include name of local UCC church in your estate planning.

Please check here_________ if you have already included name of local UCC church in your will.

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