"*" indicates required fields Name* First Last Email* Phone*Phone (Other)Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code For the Funeral/Memorial/Graveside Service of (First and Last Name)* Date of Funeral/Memorial/Graveside Service* Month Day Year Time of Funeral/Memorial/Graveside Service* Hours : Minutes AM PM AM/PM Service Location* Service Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Venue Contact Person* First Last Venue Contact Phone*Venue Contact Email* Attire Requested for Officiant Black Suit Black Dress Robe with Cross Robe without Cross Tuxedo Other Other Attire for Officiant Please describe the attire you would like the Officiant to wear. Your Assigned LoveNotes Officiant*Marty YounkinCarol SageBarron BellKen ByrdBrian DayFrank DeLeoRandy DickenThomas GreenBuster NoahMike RyherdTony SancheloKen SavageChuck SisnerosAnne SlagelChris SuttonAshley TamburinAl TaylorCharley TaylorFees and Payment Schedule Mark all applicable fees. Funeral/Memorial/Graveside Service Fees* Funeral/Memorial Service and Graveside Service ($250) – No deposit required Graveside Service only ($150) – No deposit required NOTE: No Deposit required. Please contact your LoveNotes Minister to make arrangements for payment of services. Fee may be paid directly to Minister at event. Special Notes/Instructions for MinisterConsent* I accept the terms of the LoveNotes DFW Clergy Services Funeral/Memorial/Graveside Service Agreement.*Signature* DISCLAIMER: By typing your name above, you are signing this application electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this application.Total Retainer Fee Please click the Submit button only ONE time. It will charge multiple deposits if you click multiple times.