Memorial Service Request All information will be kept confidential by Candlelight Staff Please Note: Additional charges may be incurred if the deceased is not a relative of a Candlelight member. Please fill out a Facility Use Form to accompany this form and see Candlelight’s CCF Building Rates.Step 1 of 333%Today's Date:* Date Format: MM slash DD slash YYYY Requestor for Memorial:Name* First Last Home Phone:Cell Phone:*Email Are you a member of Candlelight?* Yes NoDeceased Information:Name* First Last Birth Date:* Date Format: MM slash DD slash YYYY Death Date:* Date Format: MM slash DD slash YYYY Cause of Death:*Was the deceased a relative or friend?* Relative FriendDid they attend Candlelight? Yes NoMemorial Information:Funeral Home:*City:*Memorial Date at Candlelight:* Date Format: MM slash DD slash YYYY Time (From/To):*Set-Up Time:* : HH MM AMPM The number of adult guests expected:*The number of youth expected under age 18?*Do you wish for a Candlelight Pastor to officiate the funeral or memorial?* Yes NoName of Pastor:*Will a visiting Pastor officiate or assist in the Memorial Service at Candlelight?* Yes NoName of Pastor:*Visiting Pastor Church Affiliation:*Visiting Pastor's Phone Number:*Use of room(s):* Sanctuary Chapel (2nd floor) Main Lobby Kitchen GymDo you have a piano player, singer or music?* Yes NoDo you need any audio/visual? Video/DVD shown Computer/projector Piano Record event Stream eventAn honorarium for the Pastor is appropriate. See CCF Building Use Rates for other costs.Please include any additional information: