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– 135 Years of Ministry –
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Cemetery Internment Request
Name of Deceased
*
First
Last
Date of Death
*
MM slash DD slash YYYY
Birthdate
*
MM slash DD slash YYYY
Date of Interment
*
MM slash DD slash YYYY
Service Time and Place
*
Funeral Home/Mortuary
*
Contact Person
*
Relationship to Deceased
*
Contact Number(s)
*
Email Address
*
Mailing Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Was deceased a Riceville Church member?
*
Choose One
Yes
No
If yes, How long?
List all relatives who are current Members of Riceville
Relationship
Was deceased a member of Christian Union?
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Baby Dedication Request
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Cemetery Internment Request
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Foyer Display Request
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Benevolent Request
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Room Scheduling Request
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