Funeral Reservation

Media request form to be completed after confirming reservation with Church official. Contact: funeral@nhmbcseattle.org

Family Contact *

First

Last

Contact Phone

Contact Email *

Service Date *

Time

Deceased Name *

Enter full name of deceased, including titles and/or suffix.

Sunrise (Date of Birth) *

Sunset (Date of Death) *

Photo Upload

Click or drag a file to this area to upload.

Upload photo of deceased, if available.

Service Broadcast Preference *

Video Media Preference *

Audio Media Preference *

Message to Media

Use space provided for additional details. request or questions (optional)

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