Request to Schedule a Funeral

Request for Funeral at Christ the King

We are sorry for your loss. Please fill out the Basic Information and Clergy will contact you to arrange details. If you would prefer, please contact The Rev'd Richard G. Proctor at (850) 267-3332 or to set up a conversation.

Full Name of the Deceased*
Next of Kin Name*
Who is planning the funeral?*
- Next of Kin
Contact Information for Planner - Name (if not next of Kin), Telephone, Email and Mailing Address*
Requested Funeral Date*
Date Format: MM slash DD slash YYYY
Requested Funeral Time*

: HH

MM
Last Address of the Deceased*
Date of Deceased Birth*
MM
DD
YYYY
Date of Deceased Death*
MM
DD
YYYY
Was the Deceased a Member of Christ the King? If not, please describe the relationship of the Deceased to Christ the King.*
- Yes