Thank you for taking the time to remember our classmates
who have passed before us.
 
Name of Classmate
(Please include maiden name)
Date Passed
Date of Birth
Other information you would like to include


When your own day comes that you join our other angels,
we will honor your memory also.
Please provide us with contact information for Next of Kin
should something happen to you.
 
Your First Name
Middle Name
Maiden Name
Married Name
Date of birth (MM/DD/YY)
Next of Kin to Contact
Relation to You
Phone (w/Area Code)
Email Address
Alternate Email Address
Mailing Address
Street Address
City
State
ZIP
Other Information


(If you have more than one "Next Of Kin: contact, please submit another form)
 Thank you
 "Life is a Banquet, so . . . Belly Up!"