Memorial Service Questionnaire

Memorial Service in Alice Millar Chapel or Jeanne Vail Chapel

General Details & Contact Information

This is the description of your section break.
Name of person submitting the form Name of person submitting the form First Last
Email address of person submitting the form
Departed person's name: Departed person's name: First Last
Relationship to the University

Alumni, former faculty member, etc.
Chapel Preference:
Service Start Time Service Start Time : HH MM AM/PM
Service End Time Service End Time : HH MM AM/PM
Estimated Number of Attendees:
Must be a number less than or equal to 48.
Current state guidelines limit gathers to 50 people. To allow for 2 staff members we require less then 48 attendees.
Name Of Celebrant Name Of Celebrant First Last
A Celebrant leads the memorial service. This can be a religious official or a non-religious MC.

University Chaplains may be asked to serve as celebrant based on their schedule. Their stipend is not included in our Memorial Service Package Rate.
Will any remains be present at the service?

Will any remains be present at the service? No remains will be present An urn will be present A casket will be present (closed) A casket will be present (open)
Brief Description of Service:

Prelude, Welcome/ Gathering/ Invocation,
Call to Worship, Scripture, Scripture, Meditation, Eulogists, Community Prayers, Closing, Postlude
Chapel Setup Details
Will flowers be delivered for the service?
How would you like the chancel (stage) set up?

Ex. : Any chairs, tables, photo easel, altar forward or alter pushed back
How would you like the narthex (lobby) set up?

Ex.: Tables for programs, easel of photo, etc.
How many pews would you like reserved for family?
Will you have ushers?
Will you have programs for the service?

Please note we do not print any programs in house
Will you use the stationary, elevated lecterns or need a portable lectern place on the ground level?
Will you need any additional AV equipment? Please check what you need.

Will you need any additional AV equipment? Please check what you need. Handheld Wireless Microphone Lavilere Wireless Microphone TV Monitor Other Other

The TV monitor can be used for a photo slideshow
Closing Details
Will you have a reception or repass after the service? If so, where?
Will any flowers or accouterments be picked up by the florist?

Memorial Service Questionnaire

Memorial Service Questionnaire

General Details & Contact Information

Chapel Setup Details

Closing Details