BereavementForm – Windsor Village

If you recently experienced the passing of a loved one and would like to notify the church, please fill out the form below.

Your Name*
Prefix First Middle Last Suffix
Are you a WV Church Family Member?*
- Yes
- No
Your Phone*
Alternate Phone
Your Email*
Enter Email Confirm Email
Your Address
Street Address Address Line 2 City State ZIP Code
Relationship to Referral*
Age of Passing
Who Passed*
Prefix First Middle Last Suffix
Date of Passing
MM slash DD slash YYYY
Their Spouse
First Last
Were they a WV Church Family Member?
- Yes
- No
Their Address
Street Address Address Line 2 City State ZIP Code
Funeral Home Name
Funeral Home Phone
Visitation/Wake/Service Venue
MM slash DD slash YYYY
Visitation/Wake/Service Location
Street Address Address Line 2 City State ZIP Code
Funeral/Memorial Date
MM slash DD slash YYYY
Funeral/Memorial Service Venue (if at a different location than above)
Funeral/Memorial Service Location
Street Address Address Line 2 City State ZIP Code
CAPTCHA

Name*
First Last
Gender*
- Male
- Female
ENTER YOUR EMAIL ADDRESS*
Preferred Phone
PHone Type
- Mobile
- Home
Would you like to receive text messages of upcoming events & activities? Message & Data Rates May Apply. (If you select YES, you will be added to the distribution.)
- Yes
CAPTCHA
Phone
This field is for validation purposes and should be left unchanged.

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