Funeral Information Name of Deceased * First Name Last Name Date of Death MM DD YYYY Family member(s) contact information Pastor Officiating Pastor Scott Paczkowski Pastor Meghan Davis-Brass Pastor Bill Ekhardt Pastor Emeritus Ken Arentson Funeral Home involved? Yes No If yes, which Funeral Home? (please provide contact information) What is the commitment from the Funeral Home on the day of the funeral? (i.e. will they be attending and assisting?) If not, who will be ushering? Will the funeral home be paying the pastor, organist, &/or others participating in the funeral? Yes No If not, who is the family contact for payment for the pastor, organist, &/or other participants? Minimum Pastor Fee - $200 Minimum Organist/Pianist Fee - $150 Minimum for other Musicians - $100 Minimum for Audio/Visual Tech - $100 Will you be requesting a live-stream of the service? Yes No Please select which applies to you: there will be a casket there will be an urn there will be no physical presence of the loved one Visitation? Yes No If yes, please list date, time, and location Special requests or issues for the visitation? Date/Time Requested for the Funeral/Memorial service: Location of the service Funeral Home Westminster Sanctuary Westminster Chapel Is there a Graveside Committal? Yes No If Yes, where? Bulletin prepared by Westminster? Yes No Insert Only Number of people expected Is the Family using Simmerman Lounge? Yes No Organist/Pianist supplied by the church? (If at Westminster, it must be the church organist, unless previously approved by the officiating pastor.) Yes No Soloist? Yes No If yes, is the soloist expected from the church, funeral home, or family? Music Selections: Please indicate if music should be inserted in the bulletin Do you need any of the following: Tables TV for display DVD for display Is there a Reception? Yes (if yes, please fill out the rest of the form) No (if no, skip to last question) What kind of Reception? Coffee/Drinks only (Presbyterian Women will assist in serving - Recommended Donation of $75) Food Reception (Presbyterian Women can assist in serving by request. (Recommended Donation of $125) Catering for food is required. Arrangements are expected to be made by the family. We recommend the HyVee on University and 73rd, or the University on Douglas in Urbandale.) Reception Details Any other details Thank you!
