St. Joseph Parish Maysville Bereavement Form

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Questionnaire for Funeral Mass Planning

Name of Deceased *

Date of Death *

YYYY

Relative/Individual Handling Funeral Arrangements *

Email Address of relative/individual handling funeral arrangements:
*

Funeral Home's Name *

What Cemetery Will Body Be Buried *

Date Requested to Conduct Funeral Mass *

YYYY

Time Requested to Conduct Funeral Mass *

Time

Wait Service w/ Open Casket? *

Yes

If conducting Wake Service, then establish time here: *

Time

Any Special/Certain Request From Family? *

Yes

Describe Here in Detail Bereaved Family's Request: *

Will Family Place the Pall on the Casket? *

Yes

If yes, provide names (pall on the casket) here if known:

Will Family take up gifts at the appropriate time during Mass? *

Yes

Will Family serve as lectors during funeral mass? *

Yes

If yes, provide names (lectors) here if known:

Will Family Serve as Extraordinary Ministers of Holy Communion during Funeral Mass? *

Yes

If yes, provide names (Extraordinary Ministers) here if known:

Does Family desire Rosary to be recited prior to Funeral Mass? *

Yes

If yes, provide names (rosary) here if known:

Does Family desire expressions at the appropriate time during Mass? *

Yes

Does Family desire a musician? *

Yes

If yes, then advise Family that they will be responsible for paying Musician(s):

Does Family meet the criteria to offer a repast following the burial? *

Yes

Does Family desire a repast? *

Yes

If yes, provide estimated number to attend:

Is vehicle transportation available for pastor & deacon to cemetery? *

Yes

Final Comments/Notes: *

Bereavement Ministry Chair *

barne924@bellsouth.net

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