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As the Class Rep at a funeral, you will be representing your classmates and obtaining information to assist in the writing of a memorial article for the deceased. It is requested that you attempt to obtain as much of the following information as possible within the normal confines of respect and dignity toward the deceased's loved ones.
Please return whatever information you are able to obtain to the Memorial Articles Representative or other duly identified member of your class.
If you do not know the individual, fax the form to:
Tony Ferraiuolo
Director, Class Support Program
845-446-5325
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1.
GENERAL INFORMATION |
Name of Deceased |
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Class |
Cullum # |
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Date of
Death |
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Place of
Death (City & State) |
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Cause of
Death |
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Place of
Burial |
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Classmates or other graduates
attending wake or funeral |
Address |
Relationship
(room/teammate, etc.) |
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Which classmate(s) or other grad(s) (other than above) were close to the deceased as a cadet/in military service, etc.? |
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Did any classmate discuss/volunteer to write the memorial article?  Yes No
If yes, please provide name and any other pertinent information.
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If no,
are you aware of any classmate or friend who might be able to write
the memorial article?
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Did any
classmate give a eulogy? Yes No
If yes, please provide name and any other pertinent information.
(Please try to obtain copy of eulogy.)
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Eulogy
attached? Yes No |
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Is a
memorial fund being established? Yes No
If yes, please provide information.
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2. NEXT
OF KIN |
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Name |
Relationship |
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Address |
Phone # |
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City |
State |
Zip |
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E-mail
address |
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Will
this be the NOK residence for the near future? Yes No Unknown
If no, please provide forwarding address:
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Address |
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City |
State |
Zip |
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E-mail
address |
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Is there
someone who the NOK would prefer to write a memorial article? Yes No
If yes, please provide name and address:
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Address |
Phone # |
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City |
State |
Zip |
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E-mail
address |
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Surviving Children |
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Name |
Approx. Age |
USMA
Grad/Class |
Other Info |
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3. OTHER
INFORMATION |
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Please
fax or mail to the address at the top of the page. |
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A
photo of deceased acceptable to next of kin |
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Copies
of any/all eulogies if available |
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Copies
of newspaper articles relating to the deceased |
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Mass
cards or other church/memorial service handouts on the deceased |
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