ACDA Resolution of Condolence

The purpose of this Resolution of Condolence form is to gather information and facilitate the process of honoring a deceased member of ACDA. Other than the member's name, each of the fields below are optional.

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Contact Information of the Submitter of this Form?
(Name, Email, and Phone) *
Your relationship to the deceased? (Colleague, Friend, etc...) *
First Name of the Deceased Member *
Middle Name of the Deceased Member
Last Name of the Deceased Member *
Did the member hold any leadership position at the state, region, and national levels?
Member's State Affiliation
Link to Online Obituary
Who should the framed resolution of condolence certificate go to? Please include an address and phone number, if known.
(Family member, memorial service facility, etc.)
Date of the Memorial Service (if known)
MM
/
DD
/
YYYY
Time of  the Memorial Service
Time
:
Location Address of Memorial Service
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