Roy Funeral Home Online

To place a request for a REPASS Event, please user the submission form below.

Client Full Name (i.e Mary Johnson, or Johnson Family)

Representative Name

Funeral Home Representative in charge of event

First Name

Last Name

Representative Phone

Funeral Home Representative

(###)

###

####

Funeral Representative Email

Requested Service Date

YYYY

Event Start Time

Hour

Minute

Second

Event Location

Service Requested

Do you need event support?

PACKAGE LEVEL

BASIC, SILVER, GOLD, CUSTOM

Number of Guests

Entree

Entrée 2 (Optional)

If you have selected the Silver or Gold package, please select a 2nd entrée

Special Accommodations

Place any special requests or needs here

Side Option 1

Side Option 2