Deceased Input Form
FIELDS MARKED WITH
*
ARE REQUIRED!
Name of Deceased:
*
High School Name:
*
Class of:
*
Date of Death [xx/xx/xxxx format]:
Cause [Optional]:
Memorial Statement:
Memorial Fund Established: [Including mailing address]:
Name of Person Submitting This Statement:
*
Relationship to Deceased:
*
Person Submitting This Statement:
*
[Put your email address here in email format: xxxxxx@xxx.com]
CPPHSAA
Attn: Dave Conlin, "Prez"
1554 Caton Road
Corning, NY 14830
Clear and Start Over Button will clear the form without processing any data.
E-mail Form Now Button will send the form data to the CPPHSAA by E-mail.
Data will be used in updating the Deceased List for Classmates of the School designated on the form.
"E-mail Form Now" Button will include the sender's e-mail address from which the submission was made in the "HEADER" of the e-mail.
The Corning Painted Post High School Alumni Association wishes to express our sympathy for the loss of one of our alumni. We want you to know that we will not forget our former classmate and friend. We offer you the opportunity to record any message, or to list any memorial fund that has been established for our old friend to be included in future class memory books.
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