Date of birth *

MM

DD

YYYY

Date of death *

MM

DD

YYYY

Contact person's name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Preferred method of contact *

Email

Phone call

Text

Will you need a pianist? *

Yes

No

Unsure at this time

Would you like to have a table for photos/memorial items?

Yes - in the Fellowship Hall with the reception

Yes - in the Narthex (no reception)

No

Unsure at this time

Will you have an urn to display in the sanctuary?

Yes

No

Unsure at this time

We generally do not Livestream memorials, but we can offer up a recording of the service. If you have a majority of guests from out of town and would like to discuss the possibility of a Livestream version of the service, please indicate so here. Note that we would need two A/V technicians in that case.

Yes, I am interested.

No, just the recording is enough.

Would you like us to announce the memorial in our weekly electronic newsletter, so the HSLC community can be invited? *

Yes, please add an announcement in the eNews

No, please do not announce the memorial in the eNews

Do you wish to hold a reception here after the service? *

If yes, please know that the church will provide a coffee/tea service if desired. Additionally, cookies can be purchased by the Reception Coordinator who will need to be reimbursed directly.

Yes

No

Unsure at this time

Will you have a slideshow to display during the reception?

Yes

No

Unsure at this time