| NAME OF DECEASED |
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| DATE OF DEATH |
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| DATE OF BIRTH |
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| YOUR NAME |
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| WAS THE DECEASED A MEMBER OF CBBC |
|
| IF NO, RELATIONSHIP TO A CBBC MEMBER |
|
| WHAT FUNERAL HOME WILL BE USED |
|
| DATE OF VIEWING / VISITATION |
|
| TIME OF VIEWING / VISITATION |
|
| DATE OF FUNERAL |
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| TIME OF FUNERAL |
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| LOCATION OF FUNERAL |
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| NAME OF PASTOR PERFORMING SERVICE |
|
| FAMILY CONTACT PERSON |
|
| CONTACT PHONE NUMBER |
|
| ADDRESS TO SEND MEMORIALS |
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