Burial Request Form

Our Burial Request form is designed for on-line completion and submission. Please call to confirm that we have received your order.

* Denotes a required field.

Part I: The Funeral Director

Funeral Home or Crematory

Funeral Director

Email *

Contact information is optional for local Manchester funeral homes.

Address 1

Address 2

City

State

Zip

Telephone

Fax

Part II: The Deceased

Name

Date of Birth

Date of Death

Age at Death

Place of Death

Last City of Residence

Next of Kin or Primary Contact

Street Address, City State Zip

Telephone

Part III: The Funeral Service

Date

Time

Church Funeral Home Other

Part IV: The Burial Lot

The deceased owns or has right of burial in the New Saint Joseph Cemetery

Section / Block

Lot Number

The deceased owns or has right of burial in the Old Saint Joseph Cemetery

Avenue / Walk

Lot Number

Part V: The Container

Full Burial Cremation Unsealed Doric Grave Box Sealed, Painted Doric Grave Box Lined, sealed Doric "Titan" Third-Party vault (Wilbert, etc.)

Part VI: The Committal

November 1 - March 31: (Must take place in the Shaw Chapel, No winter graveside services) April 1 - October 31: (Please select from the following options)

Graveside Graveside & Tent Chapel

Part VII: Special Instructions

For example: did the deceased have a preferred burial order?

Will there be a military honor guard?

Do any members of the immediate family have special needs or requests?

For more information or to make an appointment please call (603) 622-9522 or email info@stjcem.org.

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