Funeral/Celebration of Life Request Form
Please fill in as much information as you have available at this time. Please note that completing this form does not confirm your ceremony plans. Our office will be in touch to confirm details and provide next steps to meet with a clergy member as soon as possible.
Primary contact name
First
Last Name
Relationship to the deceased
Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Personal Information
Name of the deceased
First and Middle Name(s)
Last Name
Preferred name to be used during the service
Pronouns
She/Her
He/Him
They/Them
She/They
He/They
Any/All Pronouns
Other
Date of birth
/
Month
/
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date of death
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was the deceased a regular attendee of MCC Toronto?
Yes
No
Unknown
Service Information
Funeral Location
MCC Toronto (115 Simpson Ave. Toronto)
Graveside Service
Offsite Funeral Home
Other
Date requested for funeral
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Approximate number of Guests Attending
Clergy preference
Rev. Junia Joplin
Rev. Deana Dudley
No preference
Other
Would you like to include any of the following in the service?
Video/Webcast Technician (operates a live YouTube feed that can be shared online)
Sound Technician (operates music, sets up microphones for singers, readings, etc.)
PowerPoint Technician to make/operate a presentation of photos, music lyrics, etc.
Live Pianist
Additional Information
Is there anything else you would like to make us aware of at this time?
Submit
Should be Empty: