The Office of The Bronx Borough President: Bronx Virtual COVID Memorial

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To submit information about a Bronxite who was lost to COVID-19 on the website of The Office of The Bronx Borough President, please fill out the form below. Once we've received your submission, we will send you an email to ask if you'd like to include a photo to include when posting your submission.

Name of person to memorialize *

Your name *

Your relationship to person to be memorialized *

Your email address *

Your phone number

Please share a brief explanation of why this person was special to you *

I hereby state that all information I have submitted on this form is valid and truthful and grant permission to the Office of The Bronx Borough President to use the name, likeness and memorial words written on its website. *

I accept*

Required

Please type your initials *

Submit

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