Wedding Video by Carol, Burbank, California

Funeral Video Contract Request

Simply submit this information to book my services. I will email a completed contract to you as confirmation. I will bring two copies with me to the funeral and we can sign & make full payment at that time (cash or check). You can pick-up the videos from me (usually) within the week - or I can mail it.

Your First & Last
Name:
Your E-mail Address:
Your Phone #:
Your Physical Address:
Your Relationship to Deceased: (ie "Family Friend")

The Funeral Day & Date:
Name of Funeral Home:
Address of Funeral Home:

Video Package Choice:
How many copies do you need?: Extra copies are $15 each.
Address(es) DVDs should be mailed to:

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Start Time for Video Coverage: (
I will arrive 30 minutes early)
End Time for Video Coverage:
Actual Start & Time written on the announcement:
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Name of Deceased:
Date of Birth:
Date of Death:
Survivor's relationships to deceased: (ie. He is survived by mother, siblings, wife, children, grandchildren, cousins, friends) This info is used on the cover and/or ending of the video.

Additional information you want me to know: (ie.number of guests, circumstance of death, if relevant)