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    Funeral and Memorial Enquiry Form

    We are sorry for your loss. Please complete this form and a member of our clergy or office team will contact you shortly.

    1) Enquirer’s Details

    First name

    Last name

    Email

    Phone Number

    Relationship to the Deceased(required)

    2) Details of the Deceased

    First name

    Last name

    Date of Birth

    Date of Death

    Age (if known)

    3) Service Details

    Preferred Date for Service

    Preferred Time

    Type of Service

    Location (if known)

    Funeral Director (if appointed)

    Hymns, Music, or Readings

    Additional Notes or Requests

    4) Consent

    I have read the Privacy Policy.