аЯрЁБс>ўџ 8:ўџџџ7џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС` №Пќbjbjц‡ц‡ .$„э„эќџџџџџџЄЄЄЄЄЄЄЄИ@@@@TИƒ2||||||||$Еhž(Є|||||(ЄЄ||=ккк|.Є|Є|к|ккЄЄк|p а="ѕŽЩ@ЊBкS0ƒкЛьиЛкЛЄк(||к|||||((Ф|||ƒ||||ИИИd $ИИИ ИИИЄЄЄЄЄЄџџџџ Funeral Pre-Planning Worksheet This worksheet is designed to assist you in pre-planning your funeral or memorial service. It’s a tool for describing the spiritual legacy you would like to leave those who will gather to remember you after you have died. Because your plans and circumstances may change, please review and revise this worksheet periodically. Whenever you revise this plan, please make sure to file copies with • The church office • Your preferred funeral home • Your next of kin • Anyone else who should have this information. Date this plan was completed:____________ Full Name (first, middle, maiden, last names):______________________ Mailing address:_______________________________________________ Home phone: ________________ Work phone: ________________ Cell phone:______________ Email address:__________________________ Date of birth:______________ City of birth:_________________ Dates and locations where you were baptized and confirmed:_____________________________________________ Full name of spouse(s)__________________ Date(s)/location(s) of marriage(s):___________________________ Names of parents, including mother’s maiden name: (Father)_______________________ (Mother)________________________ (Mother’s maiden name): ___________________ If for some reason the church office is contacted, should you become incapacitated or die, whom do you regard as your next of kin? Please give complete name[s] and contact information. In naming siblings, children, grand-children and great-grandchildren please note those who are deceased. You may also wish to include the names of spouses of these family members. Names of siblings:____________,_______________,_____________,____________, ____________,_______________,______________,____________, Names of children: ___________,_______________,_____________,____________, ____________,_______________,______________,____________, Names of grandchildren: _________,_______________,_____________,____________, ____________,_______________,______________,____________, Names of great-grandchildren:_______________,_____________,____________, ____________,_______________,______________,____________, 1 Names of other survivors:______________,________________,_____________, _______________,_________________,_____________ What is your preference for disposition of your remains? If your remains are to be buried, in what cemetery? Do you wish to have a _____ funeral (with body present) or ____ memorial service (following cremation, burial or other mode of disposition of your remains). Do you wish to have your service at:_____________________ or e.g. funeral home? Do you wish to have your funeral/memorial service include Holy Communion: ___ (yes) ___ (no)? What congregational hymns would you like sung during your service?__________,_________,________________ Which musician(s) do you prefer to provide instrumental music for your service? Which vocalist(s) do you prefer to sing at your service? What scripture readings would you like to have read at your service? Normally the service includes a psalm, an Old Testament reading, a New Testament reading and a Gospel reading. Which lay persons do you wish to read the personal reflection/tribute, etc.? Which family members or friends do you wish to serve as casket-bearers? What wishes, if any, do you have for the lunch following your funeral/memorial service? Please attach a sheet(s) describing • Information to be included in your obituary • A brief personal statement of your Christian faith • A description of ways you have lived out your faith in daily life • A list of ways you have served here at Our Savior’s and/or in the wider church • Your preferences regarding flowers, memorial gift designation(s), etc. • Any other information you think would be helpful to your survivors 2 May include great-great-grandchildren, nieces, nephews and others you would want named in your obituary.  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