Name of Deceased* First Middle Last Date of Deceased Birth* Month Day Year Date of Deceased Death* Month Day Year Building UseUse of facility for service Price: $375.00 Quantity: Building Use Deposit*Refundable upon successful inspection by staff Price: $50.00 Quantity: MinisterMay be discussed with the minister. If outside of Rochester, ministerial fee plus expenses (standard published IRS rate/mile; overnight hotel accommodations. Price: $500.00 Quantity: Organist/PianistIncludes consultation, rehearsal with other musicians(s) Price: $250.00 Quantity: Audio/Visual Technician Price: $150.00 Quantity: Audio/Visual Needs PowerPoint Production (family provides content) Live Stream of Service Recording of Service Audio Technician (required if using outside musicians) 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