Remembering those we lost to COVID-19
Lost amid the growing number of coronavirus deaths in and around Bloomfield are the stories of those now gone.

The Bloomfield Information Project wants to help you celebrate those stories. Answer a few questions below to tell us about someone our community has lost to COVID-19. What you share will be added to a memorial page on our website at bloomfieldinfo.org/covid-19-memorial, available for republishing on other websites, and archived.

It is a historic time for our community. And those we've lost deserve to be a part of history.
What is the full name of the person who died from the virus? *
What pronouns should we use to refer to them? *
What was your relationship to them? *
What made this person special in your eyes? What were their passions or hobbies? Your response can range from a few words to a full story. Use this space to tell us anything you'd like about them. *
How old were they? *
When did they die? *
MM
/
DD
/
YYYY
Where did they die? *
Where were they born?
Where else have they lived?
Can you share their race? *
This information will not be included in the memorial archive but may be reported in aggregate. For example: what percentage of the coronavirus deaths in Bloomfield were of people who are Black or African American? We're collecting it because COVID-19 has had a disproportionate impact on people of color and this will provide a more detailed account of the impact of the virus on our community.
Where can people donate their money or time to honor them?
This can be a food pantry, charity, or family funeral fund. A web address is preferred.
Is there anything else you'd like to share?
You can use this space to tell us about their personality and accomplishments or to share your favorite memories of them.
Next
Never submit passwords through Google Forms.
This form was created inside of Bloomfield Info Project. Report Abuse