Bereavement

Bereavement Notification Form

The New Jerusalem Baptist Church family expresses our condolences during this time of bereavement. Although a loss of this nature is nearly a universal experience, we realize people handle these times in various manners. It is our goal to assist you in recovery from this experience while placing you on the path moving forward.

Remember, we are here to share scriptures, resource materials and prayer in an atmosphere of safety and peace.

Take a moment to complete this form, and let us help you in your time of need.

* Indicates required field

Contact Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Are You A Member Of NJBC *

Yes No

Name Of the Deceased *

First

Last

Is the Deceased An Immediate Family Member? *

Yes No

When Did the Deceased Pass Away? *

What Is Your Relationship To The Deceased *

Are You Considering NJBC for the Homegoing Service? *

Yes No

Submit