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First Baptist Cameron

Death Notice Form

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Your Information

Your Information

Name

First

Middle

Last

Relationship to the Deceased

Email

Phone

Deceased Information

Layout

Name

First

Middle

Last

Gender

Marital Status

Date of Birth

Date of Death

Spouse's full name (if applicable)

First

Middle

Last

Funeral Home Information

Choice of Funeral Home

Funeral Home Phone

Funeral Home Location

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

I request the following disposition of my body be made:

Buried
Placed in mausoleum
Cremation
Not Sure

Service Information

Name of Church

Requested Pastor

Location of the Service

Times for Funeral, Memorial, Viewing, Burial

Family Members who are FBC Cameron members and their relationship to the deceased. (To be listed in the Sunday Message Notes)