ARRANGEMENTS FORM Please complete the following: (items with an asterisk (*) are required). Name of Deceased (How it is to appear):*Family Contact Person:Family Contact Email Address: Date of Birth: Date Format: MM slash DD slash YYYY Date of Death: Date Format: MM slash DD slash YYYY City/State of Residence:Family Contact(s) Mobile Number (Used to text the obituary notification. Up to 5 mobile phone numbers may be submitted.):Visitation?:YesNoVisitation Day, Date & Time:Visitation Location's Name & Address:Service (Choose one):FuneralMemorialMassPrivateService Day, Date & Time:Service Location's Name & Address:Interment (Choose one):BurialCremationPrivateInterment Day, Date & Time:Interment Location's Name & Address:Obituary (Life description, accomplishments, etc...):Any Special Requests or Instructions:Upload Pictures (The following image formats are allowed - JPG, JPEG, GIF, PNG, PSD, PSB, DOC, DOCX, PPT & PPTX): Drop files here or Accepted file types: jpg, jpeg, gif, png, psd, psb, doc, docx, ppt, pptx. Upload funeral program (PDF is the only format allowed) or life summary (DOC or DOCX formats allowed):Accepted file types: pdf, doc, docx.Upload Videos (Up to 3 videos can be submitted. The following video formats are allowed - MPEG, MPG, MOV, WMV, MP3, MP4, AVI): Drop files here or Accepted file types: mpeg, mpg, mov, wmv, mp3, mp4, avi. Obit Code:(Leave blank if unknown)Post on social media?:YesNoCaptcha
