Vigil Honoree Submission Form
Submit the name of someone to be honored during the vigil.
Submitter Name
*
First Name
Last Name
Submitter Email
*
example@example.com
Name to be Honored
*
First Name
Last Name
Date of Passing (Optional)
City/State (Optional)
Relationship to Honoree (Optional)
Tribute or Special Message (Optional)
Upload Honoree Picture (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Permission
*
I give permission for this name to be publicly read and displayed during the March 6th vigil.
I give permission for this name to be publicly displayed on the JLD Community Solutions virtual memory wall.
Would you like to receive updates about future JLD Community Solutions and Phi Beta Sigma Fraternity, Inc. events and support spaces?
*
Yes
No
Submit
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