Pacesetter Lost Notification Form

Pacesetter Lost Death Notification Form
Please accept the Alumni Association's deepest condolences for your family's loss. May GOD continue to keep each of you in HIS loving arms during your time of bereavement. Be blessed and know GOD is truly able. "Earth has no sorrow, that Heaven can not heal." Please notify the Pacesetters' network that a Pacesetter classmate has passed. Please complete and submit our Pacesetters Lost Death Announcement Form.
Your Name

First NameLast Name
Your relationship to the Deceased
Your relationship (Husband/Wife, sibling, family member, Classmate, friend, church member, etc.)
Email
example@example.com
Preferred Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Was the deceased a Pacesetter?
Member of Pacesetter Class of:
Name of the Deceased

First NameLast Name
Place of death and age at death
Place of Death and Age at death
Nickname in school
Nickname if applicable
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Date of Death

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Please upload a picture of the Deceased(if applicable)

Cancelof
Surviving family members who attended Hayes High School. (Please add the relationship of family member to deceased. Include name, class year, and relationship.)
Surviving family members who attended Hayes High School. (if applicable)
Have funeral arrangements been completed? If "YES", please complete the next section "Funeral Service Details".
Funeral Date & Time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Funeral Service Details
Funeral arrangements: Please include the name of the funeral home, visitation date & time, place/church for service, and burial place. Funeral arrangements – Be sure to include the date, time, and location of the funeral or memorial service and the cemetery's location. State whether the service is private or open to the public.
Funeral Home Name
Funeral Home Address

Street Address

Street Address Line 2

CityState

Zip Code
Donations – Note how/where people can send flowers, donations, or other contributions.
Additional information
Please verify that you are not a robot
Should be Empty:

Pacesetter Lost Death Notification Form

Funeral Service Details