FUNERAL ARRANGEMENTS

Shining Lakes Grove, ADF

In order to prepare arrangements for services following your death we request the following information. The Grove will do its best to see that your desires are fulfilled but extenuating circumstances, such as resistance of your relatives, may impede us from completing this work. All information will be kept confidential until after your death. Upon completion of this form you should schedule a meeting with the Senior Druid to discuss your arrangements.

Name: Magical  _________________________________________________________________
      Legal:   _________________________________________________________________
Address:       _________________________________________________________________

Name & Addresses of Closest Relatives:
      Name                         Address                          Telephone
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Which relatives listed above are aware of your religious orientation?
________________________________________________________________________________

If none of them are aware do you wish for them to be informed?       Yes      No
If your family plans a memorial service that differs from your request should
the Grove make this information known to them?                       Yes      No
If a separate Neopagan Memorial is necessary are there any members of your
family who should be invited?
________________________________________________________________________________
Location of Burial Plot: _______________________________________________________
Do you desire burial or cremation? (Please circle your preference)
Do you desire calling hours?                                         Yes      No
Do you wish to be an organ donor?                                    Yes      No
Do you have a will?                                                  Yes      No
If Yes, Name of Attorney and/or location of will:
________________________________________________________________________________
Do you have a preference for memorial gifts?
________________________________________________________________________________
What is your primary Neopagan religious orientation? (Druidism, Wicca, etc.)
________________________________________________________________________________
Are there any other individuals or groups that should be informed of your
passing?
(please attach listing with contact information on a separate page)
Do you have any primary Deities which should be invoked at your memorial?
(Please list below.)
________________________________________________________________________________
Do you wish to have any items buried/burned with you (legal restrictions may
apply)?
________________________________________________________________________________
Do you have any special instructions for the disposition of your personal
religious objects?
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
List your three favorite songs or chants for possible inclusion in your memorial
service:                 
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Are there any particular poems or readings which you desire for your service?
________________________________________________________________________________
Do you have any other special requests for your memorial service?
________________________________________________________________________________
________________________________________________________________________________
Do you wish to have your name placed on the Grove Ancestor Memorial?
                                                                     Yes      No
Do you desire to be called to join the Grove's Samhain celebration each year?
                                                                     Yes      No
If yes, are there special incenses or foods that you would like to have offered
if possible?
________________________________________________________________________________
Your LEGAL signature

________________________________________________________________________________


Notary Seal