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Obituary Form
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Obituary Submission
Photos may be included and should be sent in a jpg format at a minimum of 225 dpi resolution. Black and white or color photos can be used, providing the picture is of good quality and not too small.
Please include only the most outstanding or notable achievements (or "high points") in the life of the person for whom the obituary is being written since space is limited.
Submitter's Name
Your Email
Name and Phone Number of Person Who May be Contacted in Case More Information is Needed:
Deceased Information
Name and Age of Deceased
Residence of Deceased
Place and Time of Death (Day, Date, Time)
Place and Time of Death (Day, Date, Time): Date
Place and Time of Death (Day, Date, Time): Time
Services (fill out all that apply)
Funeral Date/Time
Funeral Date/Time: Date
Funeral Date/Time: Time
Funeral Location
Memorial Date/Time
Memorial Date/Time: Date
Memorial Date/Time: Time
Memorial Service Location
Who Officiated?
Organist
Soloist
Interment is Where:
Vigil Services/Rosary Services:
Officiated by Whom?
Pallbearers:
About the Deceased:
Date of Birth
Place of birth
Father's Name
Father Living or Deceased?
Mother's Maiden Name:
Mother Living or Deceased?
Name of Spouse (include maiden name, if applicable)
Spouse Living or Deceased?
If Spouse is Deceased, Date of Death
When and Where Married?
Career Information: Give a BRIEF description of occupation, education, military or other special honors:
Other Survivors? Children's Names, Names of Spouses and Where They Live, if Applicable:
Brothers and Sisters (with spouses and where they live):
Number of Grandchildren
Number of Great-Grandchildren
Number of Great-Great-Grandchildren
Preceding in Death
Memorials May Be Made To:
Name of Funeral Home in Charge of Services: