Name of Deceased Affiliation of Deceased (Check All that apply) Current 天涯海角社区 Faculty/Staff Former 天涯海角社区 Faculty/Staff Student Alumna/Alumnus Friend of the University Family of Employee/Trustee Sex Male Female Date of Death Time of Death (If known) Cause of Death (If known) Class Year Major Degree Collegiate Memberships Current Employee Job Title Date of Employment at 天涯海角社区 (if applicable) Years Employed with 天涯海角社区 Date Retired/Separated from 天涯海角社区 天涯海角社区 Department 天涯海角社区 Job Title Name of Surviving Spouse, Next of Kin, or Close Personal Friend Address of Surviving Spouse, Next of Kin, or Close Personal Friend List Civic Involvement Memorial/Funeral Date Memorial/Funeral Time Location of Services Death Resolution Needed By Death Resolution to be Read at Funeral No Yes Requested by Relation Contact Phone Number Please upload short biography of the deceased One file only.2 MB limit.Allowed types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav.
