SUBMIT NECROLOGY INFO

TO SUBMIT NECROLOGY INFORMATION BY MAIL OR IN-PERSON, CLICK HERE FOR A PDF COPY OF THIS FORM.

DEADLINE FOR NECROLOGY INFORMATION: JULY 31, 2024

USE THIS FORM TO SUBMIT INFORMATION ABOUT FAMIILY MEMBERS WHO HAVE DEPARTED THIS LIFE FROM JANUARY 1, 2023 TO JULY 2024. UPLOAD A PHOTO OF THE DECEASED FOR SUBMISSIONS PRIOR TO JULY 15, 2024 FOR PLACEMENT IN OUR 2024 CURTIS-ALBRIGHT FAMILY REUNION SOUVENIR PROGRAM BOOK!

Please enable JavaScript in your browser to complete this form.

2024 Curtis Family Reunion Necrology Submission Form

USE THIS FORM TO SUBMIT INFORMATION ABOUT FAMIILY MEMBERS WHO HAVE DEPARTED THIS LIFE FROM JANUARY 1, 2023 TO JULY 2024. UPLOAD A PHOTO OF THE DECEASED FOR SUBMISSIONS PRIOR TO JULY 15, 2024 FOR PLACEMENT IN OUR 2024 CURTIS-ALBRIGHT FAMILY REUNION SOUVENIR PROGRAM BOOK!

NAME OF PERSON COMPLETING THIS FORM *

First

Last

SPECIFY YOUR RELATIONSHIP TO THE DECEASED: *

YOUR CONTACT INFORMATION:

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

TELEPHONE: *

Telephone Type: *

• Mobile
• Home
• Work

If Mobile, can we text you?

• Yes
• No

EMAIL *

DECEASED INFORMATION

Full Name of DECEASED *

First

Middle

Last

Layout

DECEASED's Maiden Name *

WAS DECEASED CALLED BY A NICKNAME?

DATE OF BIRTH: *

DATE OF DEPARTURE: *

WHERE WAS DECEASED BORN? (CITY / STATE) *

WHERE DID DECEASED LIVE AT TIME OF DEATH? (CITY / STATE) *

DECEASED"S FAMILY & LINEAGE INFORMATION

NAME OF PARENT(S) OR GUARDIAN: *

Is decease OR deceased's Parent(s)/Guardian a descendant of Lewis Curtis, Penny & Adeline Albright? *

• YES
• NO

PLEASE SHARE HOW THE DECEASED'S PARENT(S) ARE RELATED TO LEWIS CURTIS, PENNY & ADELINE ALBRIGHT: *

Example: Name which of the Prime Eleven children of Lewis, Penny & Adeline. the deceased’s parents are related to -or- deceased is the spouse of a Curtis-Albright descendant, -or-, etc.

INCLUDE A SHORT SENTIMENT ABOUT YOUR LOVED ONE:

PLEASE SUBMIT A PICTURE OF YOUR DEPARTED RELATIVE FOR PLACEMENT IN OUR 2024 CURTIS-ALBRIGHT FAMILY REUNION SOUVENIR PROGRAM BOOK! Allowed file types: .pdf, .doc, .png, jpg

Click or drag files to this area to upload. You can upload up to 2 files.

WE ARE HONORED TO RECOGNIZE OUR DEARLY DEPARTED FAMILY MEMBERS ON SATURDAY, AUGUST 3, 2024!

Submit