Death Notification

Please complete the form below and submit it to notify the Eastern Province of a deceased member.

After you submit your notification to the province. you will be redirected to IHQ to make them aware of our dearly departed Eastern Province Brother.

Your Name(Required)

First Last

Your Email(Required)

Your Phone Number(Required)

Your Current Chapter(Required)

Your Position(Required)

Name(Required)

Please check spelling

First Last Suffix

Chapter of Initiation

Date of Initiation

Date of Birth

Date of Death(Required)

Do you know if the deceased brother was a member of a chapter at the time of his death?(Required)

Yes

Current Chapter(Required)

Upload a photo of the deceased member.

Accepted file types: jpg, jpeg, gif, tif, pdf, docx, Max. file size: 256 MB.

Acceptable formats: .jpg, .jpeg, .gif, .tif, .pdf, .docx

Do you have the obituary?(Required)

Yes

No, but I do have a link to the Brother's online obituary.

No, I do not have an additional information.

Do you want to upload a copy of the obituary or would you prefer copying and pasting the information below?(Required)

Let me upload the obituary

I will copy and paste the obituary below.

Upload obituary(Required)

Accepted file types: jpg, jpeg, gif, tif, pdf, docx, Max. file size: 256 MB.

Acceptable formats: .jpg, .jpeg, .gif, .tif, .pdf, .docx

Copy obituary below(Required)

Add URL to online obituary(Required)