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Nursing Student. Students having a good time in the new quad. Two graduates from developmental education.

Obituary

Form C

The following will be helpful in writing the obituary:

Full name __________________________________________________________________

Name before marriage _______________________________________________________

Date and place of birth ____________________________________________________

Father's name ______________________________________________________________

Mother’s name_______________________________________________________________

Previous residences:

(City/state and dates) _____________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Married to _________________________________________________________________

Date and location of marriage ______________________________________________

Previous marriage(s) and year of divorce/death _____________________________

Military service:

(branch of service, dates of service, rank, where stationed, achievements)

________________________________________________________________________

Education:

High school _______________________________________________________________

Graduated_____Yes _____No

College(s) Degree(s):

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Employment history:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Children:

Name/Relationship

___________________________________________________________________________

Address

___________________________________________________________________________

Spouse ____________________________________________________________________

Children___________________________________________________________________

___________________________________________________________________________

Name/Relationship

___________________________________________________________________________

Address___________________________________________________________________

Spouse ____________________________________________________________________

Children___________________________________________________________________

___________________________________________________________________________

Name/Relationship

___________________________________________________________________________

Address

___________________________________________________________________________

Spouse ____________________________________________________________________

Children___________________________________________________________________

___________________________________________________________________________

Name/Relationship

___________________________________________________________________________

Address

___________________________________________________________________________

Spouse ____________________________________________________________________

Children___________________________________________________________________

___________________________________________________________________________

Number of grandchildren ___________Number of great-grandchildren _________

Brothers and sisters:

Name/Relationship

__________________________________________________________________________

Address___________________________________________________________________

Name/Relationship

__________________________________________________________________________

Address___________________________________________________________________

Name/Relationship

__________________________________________________________________________

Address__________________________________________________________________

Memberships in organizations

__________________________________________________________________________

Special achievements or honors ___________________________________________

__________________________________________________________________________

__________________________________________________________________________

Hobbies:

__________________________________________________________________________

__________________________________________________________________________

Church ___________________________________________________________________

Time and place of funeral/memorial service _______________________________

__________________________________________________________________________

Time and place of viewing ________________________________________________

__________________________________________________________________________

Memorial contributions may be made to:

__________________________________________________________________________



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Updated April 2007 by the College Advancement Department.

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