Start a Memorial - President's -
MY CONTACT DETAILS
Name :  
Address Line1 :
Address Line2 :
City :
State :
ZIP :
Country :
Daytime Telephone :   Extension :
Cell :
e-mail :    
Relationship to Decedent: :
      : 
     
     
DECEDENT INFORMATION
Name :
Date of birth : Year  Month  Day 
Place of birth : City   State  Country
Name of parents :
Father  :
Mother (maiden name)  :
Name of Surviving Spouse/Partner :
Education :
Marriage(s) :
Name(s) of former spouse(s) :
Name if spouse deceased :
Date of death :
Military Background :
Business or Profession :
Business or Professional Affiliations :
Names of Children Living :
Names of Children Deceased :
Names of Grandchildren-Living :
Names of Grandchildren-Deceased :
Names of Siblings Living :
Names of Siblings Deceased :
Decedent Special Attributes :
Date Diagnosed with Parkinson's (ism) : Year     Month     Day 
Date of death : Year     Month     Day 
Died from :   
     : 
Service & Burial Info : Year     Month     Day     Time 
Place :
Address :
Memorial Info : Year     Month     Day     Time 
Place :
Address :
     
Please send 50 sheets of personalized stamps with Decedent's Photo :
Please send 50 sheets of Parkinson's Resource Organization stamps :  
     
Please select the photo
to be used in the US Postal Stamp		 :    (.jpg format only)  
     
Please select photos of DECEDENT
to be used in the Memorial Wall page
( 5 max, 2MB or less each, .jpg format only)		 : Photo 1 :
Photo 2 :
Photo 3 :
Photo 4 :
Photo 5 :      
     
Please select photos of FAMILY
to be used in the Memorial Wall page
( 5 max, 2MB or less each, .jpg format only)		 : Photo 1 :  
Photo 2 :  
Photo 3 :  
Photo 4 :  
Photo 5 :      
     
I wish to have a memorial keepsake of a hard covered booklet reflecting
the names, addresses and sentiments submitted by family, friends and relatives		 :  
     
  I wish PRO to using  
 
   
 
     
The Announcement should include :
:
of Decedent 
     
  : God saw you getting tired When a cure was not to be, So He closed His arms around you and whispered gCome to meh.

You fought a valiant battle and so He gave you rest: God's garden must be beautiful, He only takes the best.

And when we saw you sleeping So Peaceful and free of pain, We could not wish you back to suffer that again.
or
  :
     
Our mailing list for mailing Memorial Announcements
is attached in the following format		 :  
 
     
We would like to have an on-line guest book :
We wish to have a family blog :
     
Please embed the code of your video from www.youtube.com here :
 
(You may leave this section empty if needed)
 
Please send Silver Ribbon Pins :
Please send Personalized Tribute Envelopes for distribution :
 
Please send notification of this memorial to the following emails :

Separate e-mail addresses by a "," (i.e. Ted@domain.com,Bob@domain.com)
 
Please copy and paste the Obituary here:
 
or upload it here :     (.jpg format only) 
     
We want guests to view and sign the Guest Book :
I am interested in an event to carry on the legacy of decedent :
I am interested in recognition of the decedent by a Government Official :  
 
Thank you, your memorial will be added after payment confirmation and will appear in The Parkinson's Resource Organization Memorial Wall, if you have any question please feel free to Contact us anytime.
From all of us at Parkinson's Resource organization please accept our condolences and thank you for helping Parkinson's Resource Organization in a search for a better quality of life for everyone still living with Parkinson's disease.

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