Remembering your deceased loved ones
Please submit the name of a deceased loved one that you wish to have especially remembered throughout November, our Month of Remembrance. Please fill in each blank. Submit only one name per form submission. To submit multiple names, complete the form separately for each name you wish to provide.
Email address *
Submitted by (Last Name) *
Your answer
Submitted by (First Name) *
Your answer
Phone Number *
Your answer
Name of the deceased individual (one name per submission) *
Your answer
Birthdate of deceased *
Your answer
Date of Death *
Your answer
The deceased is your... *
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