GLA Lagos (HQ) - FUNERAL SERVICES FORM

Funeral Service Request

Service / Ministry Required

Service of Songs

Funeral Service / Interment

Both

First Name

Last Name

Phone Number

Relationship To Deceased

First Name of Deceased

Middle Name of Deceased

Surname of Deceased

Title of Deceased

Birthdate

Date of Death

Do you have a valid death certificate issued?

Yes

Would you require assistance with planning?

Yes (Service of Songs)

Yes (Funeral Service)

Yes (Both)

Service of Songs Date

Service Time

Service of Songs Venue

Provisions For Reception / Food After Service?

Yes

Funeral / Interment Date

Funeral Service Time

Funeral Service Venue

Interment / Cemetery Location

Provisions For Food After Interment?

Yes

Reception Venue