In Memoriam (Deceased Members & Colleagues)

In Memoriam

Deceased Members and Colleagues
If you know of someone who should be included on our webpage honoring deceased members and colleagues, please fill in the below form.
Your Name:*
Email:*
example@example.com
Full Name of the Deceased: *
Jurisdiction/Location of Deceased Member/Colleague: *
Organization of Deceased Member/Colleague: *
Date of Death:*

MonthDayYear
Date
Relationship to the Deceased: *
Link to Obituary (Optional):
Should be Empty: