I Have Lost a Loved One - Saint Mark's United Methodist Church

I Have Lost a Loved One

This form is to allow families who have lost a loved one to share information with Memorial Service Coordinators, Congregational Care Leaders & staff.

My Information In order to contact you in a timely manner the staff of Saint Mark’s UMC need this information.

First Name*

Last Name*

Email*

Mailing Address*

Preferred Contact Phone Number*

Deceased Information

Name of Deceased Person*
Please include the first & last name as well as the middle initial of the deceased.

Relationship to the deceased?*
Please state how the person providing the information is related to the deceased.

Saint Mark's Member*
Is the deceased a Saint Mark's Member?
YesNo

Does the deceased have relatives that attend Saint Mark's?
Please list their first & last names and relationship to the deceased in the box below.

Secondary Family Contact (if relevant)

Email Address

Do you wish to have a memorial Service at Saint Mark's?
YesNo

Preferred Date of service

Preferred Service Time

Special Notes

Someone from Saint Mark's will be in contact with you soon.

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