ለጸሎት ፍትሐተ የሚሞላ ቅጽ / Funeral Memorial Service Form

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ለጸሎተ ፍትሐት የሚሞላ ቅጽ / Funeral Memorial Service Form

የአመልካች ሥም / Applicant's Full Name *

ሙሉ መኖሪያ አድራሻ | Full Residential Address: PLEASE ENTER ADDRESS AS THIS FORMAT, EXAMPLE : 456 ELM STREET [APT # XYZ], SCHENECTEDY, NY 12345, USA. *

የቤት ስልክ / HOME PHONE *

ሞባይል ስልክ / CELL PHONE *

ከሟች ጋር ያለው ዝምድና / Relationship with the Deceased *

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