Alumni's name when they passed away (if different than above):
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Approximate date or Year that alumni passed away (enter 01/01/xx if you only know the year)
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Please list the city & state of alumni when they passed away (or list region if that is all that is known)
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Relatives' Names & Contacts: If you know the names of any of their living relatives that we could contact to gather more information and/or information on how to reach them, please provide that information here:
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If you know anything about their situation prior to their death, please list that here (marital status, occupation, children, etc)
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Please list any notable achievements you recall about this student --this can be while they were a student or after they graduated:
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Please list anything you would like to say about this student as an individual
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Your first and last name (person submitting this form) in case we have questions:
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Your email (person submitting his form) in case we have questions:
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Is there anything else we should know? Please list that here. If you have a link to their obituary or their facebook page, you can post that here:
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