Information for Memorial

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Auxiliary Mailing Address: *

Decease's Name: *

Decease's Date of Death: *

At the annual state convention, there is a memorial service. If you have an auxiliary member who has passed since June 30 of the previous year, please complete the form below. Please include a photo with the submission. This information will be included in the memorial service program.

Email: *

Decease's Date of Birth: *

INFORMATION FOR MEMORIAL SERVICE

Additional Information

Memorial Service Submission Form

Auxiliary Name: *

Name of Person Submitting *

Years of Service *

Life Member (check all that apply) *

Life Member of Decease's Auxiliary

Life Member of AVSFA (State Auxiliary)

Not a Life Member

Thank you for submitting information for the VSFA Memorial Service.

Upload Photo (JPEG, TIF, EPS, PDF)

We were unable to upload your file. Please ensure your file is 10MB or smaller in size.

Office's Decease held in their Auxiliary (check all that apply) *

President

Vice President

Secretary

Treasurer

Chaplain

Historian

Parliamentarian

No office held

Phone *