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gravestone
Welcome
Hi there, please fill out and submit this memorial form.
7
Questions
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1
Name
Person filling out questionnaire.
First Name
Last Name
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2
Email
Person filling out questionnaire.
example@example.com
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3
What is your "Relationship" to the Deceased
How are you related to the deceased?
MOTHER
FATHER
SISTER
BROTHER
DAUGHTER
SON
NIECE
NEPHEW
AUNT
UNCLE
COUSIN
INLAW
FRIEND
PASTOR
CHURCH MEMBER
OTHER
MOTHER
FATHER
SISTER
BROTHER
DAUGHTER
SON
NIECE
NEPHEW
AUNT
UNCLE
COUSIN
INLAW
FRIEND
PASTOR
CHURCH MEMBER
OTHER
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4
Name
Deceased Name
First Name
Last Name
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5
Date of Birth
Deceased Birthday
-
Date
Year
Month
Day
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6
Date of Death
Deceased loved one
-
Date
Year
Month
Day
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7
Image Field
Submit your best photo of the deceased.
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