A Message from our Rector
Christian burial in the Episcopal Church is a celebration of life, remembering Christ's victory over death. Please consider this form to be a gift- a gift to you to remind you of your own resurrection as you plan the readings and hymns for your service. Please review the burial services in the 1979 Book of Common Prayer as a guide for planning your service. Burial Rite One is on pages 468-489; Rite Two is on 490-505. The Rector of St. Peter's Episcopal Church will be happy to assist you with the form at your convenience.
Name*
, AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY
Phone*( ) -
Email*
I wish the Rite I Burial Service
I wish the Rite II Burial Service
I want a celebration of Holy Eucharist at my service
I do not want a celebration of Holy Eucharist at my service
Isaiah 25:6-9 (He will swallow up death for ever)
Isaiah 61:1-3 (To comfort those who mourn)
Lamentations 3:22-26, 31-33 (The Lord is good to those who wait for him)
Wisdom 3:1-5, 9 (The souls of the righteous are in the hands of God)
Job 19:21-27a (I know that my Redeemer lives)
Other Favorite Passage-Enter Below
Other Favorite Passage- Old Testament
Romans 8:14-19, 34-35, 37-39 (The glory that shall be revealed)
1 Corinthians 15:20-26, 35-38, 42-44, 53-58 (The imperishable body)
2 Corinthians 4:16-5:9 (Things that are unseen are eternal)
1 John 3:1-2 (We shall be like him)
Revelation 7:9-17 (God will wipe away every tear)
Revelation 21:2-7 (Behold, I make all things new)
Other Favorite Passage- Enter Below
Other Favorite Passage- New Testament
Psalm 23
Psalm 27
Psalm 42:1-7
Psalm 46
Psalm 90:1-12
Psalm 106:1-5
Psalm 116
Psalm 121
Psalm 130
Psalm 190:1-11
Other Favorite Psalm- Enter Below
Other Favorite Psalm
John 5:24-27 (He who believes has everlasting life)
John 6:37-40 (All that the Father gives me will come to me)
John 10:11-16 (I am the good shepherd)
John 11:21-17 (I am the resurrection and the life)
John 14:1-6 (In my Father's house are many rooms)
Other Favorite Passage- Contact Priest
Other Favorite Passage- Gospel
178 Alleluia! Alleluia! Give thanks to the risen Lord
199 Come ye faithful raise the strain
205 Good Christians rejoice and sing
207 Jesus Christ is risen today
208 Alleluia! The strife is o'er, the battle done
210 The day of the resurrection
215 Hail the day that sees him rise
287 For all the saints, who from their labors rest
304 I come with joy to meet my Lord
335 I am the Bread of life
362 Holy, Holy, Holy
376 Joyful, joyful we adore thee
383 Fairest Lord Jesus
390 Praise to the Lord, the Almighty
410 Praise my soul the King of Heaven
447 The Christ who died but rose again
455 O love of God
474 When I survey the wondrous cross
482 Lord of all hopefulness
494 Crown him with many crowns
513 Like the murmur of a dove's song
523 Glorious things of thee are spoken
537 Christ for the world we sing!
544 Jesus shall reign where'er the sun
595 God of grace and God of Glory
608 Eternal Father strong to save
618 Ye watchers and ye holy ones
637 How firm a foundation, ye saints of the Lord
657 Love divine all loves excelling
665 All my hope on God is founded
671 Amazing Grace
680 O God, our help in ages past
685 Rock of Ages, cleft for me
688 A mighty fortress is our God
690 Guide me, O thou great Jehovah
693 Just as I am, without one plea
On Eagle's Wings
Other Requests- Enter Below
I DO NOT WANT MUSIC
Other Favorite Hymns
Names of individuals providing Family Remembrance
Please note the Family Remebrance will occur at the beginning of the service, just after the Prelude.
Pallbearers (Burial Only)
Please list the names of Pallbearers, even if honorary only (not present)
Acolytes, Eucharistic Ministers, Lectors, Ushers
Please list any requests for Acolytes, Eucharistic Ministers and/or Lectors, and Ushers. You may also request that St. Peter's choose these individuals.
I want to be buried in a casket
I want to be cremated
A casket which is simple, wooden if possible
An inexpensive casket, but not of wood
Other casket choice- contact priest
I want my casket open at the funeral
I do not want my casket open at the funeral home
I do not want my casket at the funeral home at all but want it placed closed in the church building until the time of service (a vigil in the church building)
I want no vault, considering it an unnecessary expense for the family
I want the casket placed in a vault when buried
I would like my ashes present at the service
I do not want my ashes present (memorial service only)
Place of Internment*
Columbarium, grave site, or family taking ashes, or other. List.
In Lieu of Flowers
Indicate if you do not want flowers and/or if you would like memorials made to a particular organization. State the name of the organization(s).
Funeral Home*
Preferred funeral home
Preferred Cemetary
Date of Birth* January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901
Marriage Date January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901
Name of spouse (if deceased, date of death)
Date of Baptism*
Date of Confirmation
Next of Kin 1*
Name and Address
Next of Kin 2
Last Will and Testament*
My last Will and Testament, along with other important documents, are in the hands of the indicated person.
Additional instructions or information for the newspaper eulogy
I.e. names of children, education and job highlights, etc.
Digital Signature*
It is preferred that you stop by the office to sign a hard copy of your submitted information, for your file. However, if unable, you understand, when clicking submit, that you are submitting important funeral preferences. Furthermore, you understand that, if possible, your burial rites are to take place at St. Peter's Church at a convenient time when your family and friends may join in the celebration of your resurrection lives in Jesus Christ.