Member Funeral Request Form

PLEASE READ CAREFULLY THROUGH THE FORM: The following information pertains to the use of facilities, equipment, and funeral services for persons who are ACTIVE Members of The Inter-denominational Church of God:

ALL Funeral/Memorial Services:
~ Monday-Friday ONLY ~ 3 Hours (Max) Including Viewing & Service
~ 9 AM - 5 PM

Member Service includes: (No Charge)
~ Use of Sanctuary (800 max capacity)
~ Video Tech   *NO LIVESTREAMING
~ Ushers (up to 4 -2 Ushers for less than 100 guests)
~ Homegoing Coordinator
~ Janitorial 
~ Program Design
~ Printing (8.5x11) | Up to 200 Programs

Qualified Family Member Service -  Only Member's Spouse, Parent, or Child who is not an active member of ICOG - STARTING COST of $925 includes:
~ Use of Sanctuary (800 max capacity)
 - Video Tech   *NO LIVESTREAMING
~ Ushers (2 for less than 100 guests)
~ Homegoing Coordinator
~Janitorial

~Additional services are available for a fee. Please select your requested services below:
Program design fees are as follows: 5.5x7 | Quarter booklet | $175 8.5x11 | Half booklet | $250 11x17 | Full booklet | $325
Printing fees are as follows: 800 printed pages 5X7 | $0.10/paper + $0.10/B&W or $0.20/COLOR 8.5X11 | $0.15/paper + $0.15/B&W or $0.25/COLOR 11X17 | $0.20/paper + $0.20/B&W or $0.30/COLOR

A $250 REFUNDABLE Security Deposit will be ADDED to the starting cost. AFTER the Funeral/Memorial service and repast (if applicable), a property inspection will be conducted to determine the security deposit refund.

**Qualified Family Member (spouse, parent, or child of member)

Date

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

00:00 AM/PM or N/A

00:00 AM/PM

Name

(800 Max Capacity)
Member Service:
~ Up to 4 Ushers included

**Qualified Member Service:
~ Less than 100: 2 Ushers (included in the base price)
~ 100+: 4 Ushers required (base price + $200)

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.

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