Passing Member Form

The International Board seeks your assistance.
In the event of a member's passing, we kindly request completion of the Member Passing Form. Given the absence of an official notification process at the Chapter level, we urge members with knowledge of another member's passing to promptly apprise us.
Timely notification is imperative for us to observe our funeral protocol and pay due respect to the bereaved family.

Members 's Name: *

Name (as to be placed at the memorial): *

Chapter : *

Chapter Status: *

Date of Passing: *

Special Weblink:

Wake Information:

Funeral Information:

Was Death Accidental? Yes No
Submitted By: *

Date Submitted: *

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