Death Notification - Plymouth Church

Person Submitting Form *

As the person filling out this form, please indicate your role or relationship to the deceased.

Name of Deceased Person

First Name *

Last Name *

Date of Death *

Should the congregation be notified? *

Is funeral service/memorial information known? If so, please detail below. *

(Pastor will complete the Funeral Reception Form with funeral, visitation, reception information, once known.)

Additional Information

Please include any other relevant information.

Administrative Coordinator: Please update membership status in deceased's profile and the Book of Life.