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Memorial Submission Form
Use this form to request inclusion of a friend or loved one on the MBC Memorials page.
Name of the Deceased
*
Enter the first and last name of the person who should appear on the Memorials page
City
*
Enter the city of the person who should appear on the Memorials page
Date of Birth
Date Format: MM slash DD slash YYYY
Date of Death
Date Format: MM slash DD slash YYYY
Link to Obituary
Add a Photo
*
File
Title
Upload a high quality photo to appear on the website. Please include your loved one's full name and their date of death in the title field.
Example: "First Last February 25, 2019.jpg"
Submitter Name
Name of person submitting this form
Contact Email
*
Enter the email address of the person submitting this form.
Name
This field is for validation purposes and should be left unchanged.
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Memorial Submission Form
Use this form to request inclusion of a friend or loved one on the MBC Memorials page.