Recently Departed Name Submissions
THIS FORM IS FOR SUBMITTING THE NAMES OF YOUR LOVED ONES WHO HAVE PASSED AWAY SINCE NOVEMBER 1, 2023. THANK YOU!
YOUR Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
*
Please enter a valid phone number.
Name of deceased (#1)
*
First Name
Last Name
Date they passed (approx.)
*
-
Month
-
Day
Year
Date
Name of deceased (#2)
First Name
Last Name
Date they passed (approx.)
-
Month
-
Day
Year
Date
Name of deceased (#3)
First Name
Last Name
Date they passed (approx.)
-
Month
-
Day
Year
Date
Name of deceased (#4)
First Name
Last Name
Date they passed (approx.)
-
Month
-
Day
Year
Date
Name of deceased (#5)
First Name
Last Name
Date they passed (approx.)
-
Month
-
Day
Year
Date
Name of deceased (#6)
First Name
Last Name
Date they passed (approx.)
-
Month
-
Day
Year
Date
If you have more than 6 names to submit, please submit these names, and refresh the form to submit the rest of your names.
Submit
Should be Empty: