Funeral Service Request - Koinonia Church

Phone number *

Address

Type of Service: *

Traditional Service with Casket

Memorial Service with Urn

Memorial Service without Remains

Desired Service Date: *

2nd Date Option *

Service Time Begins: *

Service Time Ends: *

Name of Decedent: *

How many guests do you expect to attend? *

Which room would you like to reserve? *

Great Room (up to 100)

Learning Center Auditorium (up to 200)

Main Auditorium (up to 900)

If Main Auditorium, will you be utilizing the Lobby for Guest Book / Display?

Are you working with a funeral home? *

Yes

No

If Yes, please list the name of the funeral home and your contact person:

Will you need more than an hour prior to service start time for any set up? If so, describe below and include times.

Standard rental includes 1 hour of setup time prior to scheduled service start and 1 hour after the scheduled service end. More can be provided depending on availability of room.

What time will you exit the facility? *

This includes cleanup and removal of personal items / decor. Standard rental includes 1 hour of setup time prior to scheduled service start and 1 hour after the scheduled service end. More can be provided depending on availability of room.

Who will officiate the service? *

I request a Koinonia Pastor

I have arranged for another officiant (Not from Koinonia)

If not using a Koinonia Pastor, provide the name and contact information of the pastor overseeing the service:

How did you hear about Koinonia Church's Facility Use? *

I am a regular Attender or Member

I have visited Koinonia Church in the past

I was referred by someone

Please let us know about your audio/video needs? *

Please note that last minute requests often cannot be accommodated because of limiting staffing and resources.

Music provided by Koinonia (pre-selected music available)

I will be providing a personally made slideshow on a USB Drive (must be received at least 48 hours in advance)

Livestream (additional fee)

Microphone(s)

Table or Mic Stands for Family / Friends to share stories

Easels (for photos)

Use of Keyboard / Piano During Service

Please list any special music requests:

Such as "I have a vocalist, pianist, etc." or "I would like to have _______ song played'