Book of Remembrance Submission Form

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Book of Remembrance

Name of Deceased (Last, First, Maiden)*
Relationship to Deceased
Relationship to BEHS (Faculty, Staff Alumnus or Friend)*
Graduation Year of Deceased (if applicable, approximate if unknown)
Birth Date of Deceased
MM slash DD slash YYYY
Date of Death
MM slash DD slash YYYY
Or provide a url to an online obituary:
Please attach an obituary, if available
Max. file size: 2 GB.
Your Name*
First Last
Your Email*
Your Phone Number*