Celebration of Life Inquiry Form

Celebration of Life Interest

Thank you for considering Roser Church to host a Celebration of Life service. Please complete and submit the inquiry form below, and we will respond as soon as possible. Thank you.

Your Name(Required)

First Last

Name of the Person we are Celebrating(Required)

First Last

Your Phone Number(Required)

Your Email Address(Required)

Your Current Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Preferred Service Date(Required)

Preferred Service Venue(Required)

Will you require a Roser Pastor to Perform the Ceremony?(Required)

Use this space to provide any other details or ask a question.

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Name

This field is for validation purposes and should be left unchanged.