Obituary form

Please submit this form to our office by 10 a.m. Thursday before the week of publication to be considered for that issue. Please use first and last names for all name fields. (If the form does not work for you, please send obituary notices directly to cclark@archindy.org)

Note: Use the "Tab" key to move between fields; print this page for your own records (if you wish) BEFORE submitting the form.

Deceased

Name:                 
*

Sex: Male  | | Female  *

Age:                     
*

Parish:                
*

Town:                  
*

Date of death: / *


Survivors:

Please be sure to include the FIRST and LAST name of any survivors.
 

Spouse:


 

Children:


 

Parents:


 

Sisters:


 

Brothers:


 

Grandparents:


 

Grandchildren:                         

(number)

Great-grandchildren:              

(number)

Great-great-grandchildren:   

(number)


(e.g., something not on this form)


Criterion subscription:

Check this box if the deceased was the last in his or her household and should have their subscription to The Criterion cancelled.


Your information:

Submitted by:      
*

Phone number:   
*

E-mail:   

   

* = Required field

 

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