Non-Member Funeral Request Form

Rental Date: *

Date of the funeral

Type of Service *

Point of Contact: *

Phone number *

Address

Name of Deceased: *

Check all the additional services that apply: *

Please check ALL services needed. Only services requested (upon availability) will be provided.

Officiant

Eulogist

2 Additional Ushers (required for more than 100 guests)

Musicians

Singer

Video Tech

Program Design

Program Printing

Repast

None of the Above

Time of the viewing: *

00:00 AM/PM or N/A

Time of the service: *

00:00 AM/PM

Funeral home: *

Name

Number of estimated guests attending the service: *

~ If less than 100: 2 Ushers (included in base price)
~ If 100+: 4 Ushers required (base price + $200)
~ 800 Max Capacity

ICOG reserves the right to deny future rentals if our policies are not followed. *

Please check to indicate that you have read, understood, and agree to abide by the guidelines for ICOG facility rental. We have the right to withhold your deposit if the facility space used is not properly put back in order.