Name of Deceaced* First Middle Last Date of Deceased Birth* Month Day Year Date of Deceased Death* Month Day Year Building Use QuantityUse of facility for service Price: $100.00 Quantity Building Use Deposit Quantity*Refundable upon successful inspection by staff Price: $50.00 Quantity Minister - No Charge QuantityMay be discussed with the minister. If outside of Rochester, ministerial fee plus expenses (standard published IRS rate/mile; overnight hotel accommodations. Price: $0.00 Quantity Organist/Pianist QuantityIncludes consultation, rehearsal with other musicians(s) Price: $200.00 Quantity Audio/Visual Technician Quantity Price: $125.00 Quantity Audio/Visual Needs PowerPoint Production (family provides content) Livestream the service Recording of service Sound Technician (required if using outside muscians) Total $0.00 Date of Memorial Service* MM slash DD slash YYYY Approximate Number of People Expected at the Service*Reception to be Held at First UU?* Yes No Options* First UU Provides Historical Silver Coffee Service First UU Provides Reception Service Set up First UU Provides Food and Drink (Price to be determined) None of the Above Questions/CommentsName:* First Last Email:* Phone