Memorial Service Pre-planning Information

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Memorial Service Pre-planning Information Chapel Hill Presbyterian Church 7700 Skansie Avenue PO Box 829 Gig Harbor WA 98335 (253) 851-7779 www.chapelhillpc.org

Dear Friend: Additional Notes Does the idea of planning your own memorial service seem unusual to you? Well, perhaps it s not very common but actually, it makes a great deal of sense. Who knows better than you the way in which you would like to have your life and faith celebrated upon your death? Most of us prepare a will as part of the stewardship of our life. We want to minimize the decisions our loved ones must make during a time of great personal stress. And we want to be certain that our desires are understood and fulfilled. It should be no less true for our own memorial service. By taking a few moments now to briefly state your desires for your own memorial service, it will greatly simplify the process. Please fill this form out as completely as possible. Make one copy and keep it with your will. Return the other copy to Chapel Hill and we will place it on file. Please inform the executor of your estate that you have done so. We trust that this will be a useful tool for you. May God bless you with a long and productive life. Your brother in Christ, Dr. Mark Toone Senior Pastor Chapel Hill Presbyterian Church Revised November 25, 2003

Final Arrangements Do you want to be cremated? Yes / No Do you want to be buried? Yes / No Do you have a pre-burial document on file with a funeral home or elsewhere? Yes / No If so, where Preferred Cemetery: Address Phone/Contact Name A note to my family Chapel Hill Presbyterian Church P.O. Box 829 Gig Harbor, WA 98335 Tel: (253) 851-9991 Fax: (253) 858-7953 The following information, comments and desires are my suggestions, as of this time and date. They are subject to change due to unforeseen circumstances. They are given to you as a guideline that I hope will be helpful when these decisions need to be formalized. With all my love and affection, Committal Service Do you wish a grave side committal service? Yes / No If so, do you want family only or open to the public? Would you prefer the service prior to or after the memorial service or would you prefer to leave that decision to the convenience of your family? Signature Printed Name Date

Memorial Service Pre-planning Information Full Name: (including Maiden Name, if applicable) Birth date: Birthplace: My Social Security Number: Family Information: Circle names of those you definitely want mentioned in the service. Note those who have predeceased you. Indicate date, details, etc. that are relevant and which you might wish mentioned. Service Details Clergy or Pastor preferred: Soloists/Musicians preferred: Who else do you want to participate in the service? My Father s Name: My Mother s Name: My Marital Status: Spouse: (including Maiden Name) Date of Marriage: Place of Marriage: Children: Please list full name and if applicable, spouse and child(ren). Do you want the congregation to sing? Yes / No Do you want open sharing in the service? (i.e., any who wish may say a few words) Yes / No Do you want flowers? Yes / No If not, which organization(s) would you want remembrances sent to in lieu of flowers? Remembrances may be made to the following church or charity:

Favorite scripture passages. Circle those to use in your service. Siblings: Please list full name and if applicable, spouse. Others: Please indicate relationship. Favorite hymns and choruses. Circle those to use in your service. Memorable Marriage & Family Moments: What events in your family life would you want mentioned? Pick those which are particularly reflective of your family s personality (e.g., late night pinochle parties, special yearly vacation traditions, etc.)

Education: Please include name of school, year graduated and location. Noteworthy Accomplishments: This could be of any kind academic, sports, career, etc. Don t be shy. If it was meaningful to you, it will be meaningful to your loved ones to have it remembered. US Military Veteran? Yes / No Branch of Service: Location of Military Discharge Papers: Career Information: Please include job title, kind of business, other pertinent history. Spiritual Background: Church affiliations (Length of membership; significant contributions/service, etc.) Memberships in clubs or organizations: Personal spiritual journey [include what you would like shared. e.g., when and under what circumstances you received Christ; spiritual milestones in your life (camp, mission trip, special worship service, Billy Graham Crusade); mentors.] Please be as exhaustive as you wish. Use another page if desired. Hobbies/Interests: