Obituary Announcement Request
JSGA will provide this service to its members upon the death of JSGA member or its immediate family member (defined as spouse, children and parents)
Your Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Information about the person who passed away
Deceased Name
*
First Name
Last Name
Age
*
Was he/she a JSGA member?
Please Select
Yes
No
Back
Next
Related JSGA Member's Name *Name of JSGA Member who is related to person who passed away.
Related JSGA Member's Name
*Name of JSGA Member who is related to person who passed away
Relationship to JSGA Member
Please Select
FATHER
MOTHER
BROTHER
SISTER
SON
DAUGHTER
SPOUSE
OTHER
Place of Death
Date OF DEATH
*
-
Month
-
Day
Year
Date
Survived By Example: Son: XXX (son) & YYYY (his wife) Shah, Daughter: YYYY (Daughter) & XXXX (her husband) Shah, Brother: XXXXX (brother) & YYYYY (his wife) Shah, and Grand Children: xxxxXX, yyyyYYYour answer
*
Funeral Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Funeral Duration
Please Select
1 hr
2 hrs
3 hrs
4 hrs
Funeral Location (Address)
Prayer Date
-
Month
-
Day
Year
Date
Time
Hour Minutes
AM
PM
AM/PM Option
Prayer Location
Upload photo of deceased
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: