Memorial Submission

Memorial Submission

Please use the form below to submit a memorial. We will post it as soon as we can. Please provide us with as much information as possible. We will only post the deceased personal information. Your contact information will be used for internal verification purposes only and will not be posted online unless you have checked the box at the end of this form. Thank you for your help.

We do not sell or rent our visitor information to any outside party under any circumstances.
We believe in No-Spam privacy policy.
Only OKADVERTISING.NET have access to this information.
We can scan your photos free of charge !!! Click here for our address. Please make sure to include a self-addressed stamped envelope for the return of your photos.

1. Please provide the following contact information:
Your full name:	* Required
Subject:	*
Your Email:	*
Homepage URL :
Street Address:	*
Address (cont.):
City:	*
State:	*
Province:
Zip/Postal Code:	*
Country:	*
Work Phone:	*
Home Phone:	*
Cell:
FAX:
Relationship to the deceased:	*
If other, please explain it here:
In order to ensure the accuracy of this information, please tell us why you are the best candidate to submit this memorial.
	*


2. Please identify and describe the deceased person:
Full Name:	*
Employer:
Occupation:
State/Province:	*
Country:	*
Date of Birth:	*1978*
Age:
Sex:	Male Female
Ethnicity:
Marital Status:	*
If Other, please explain it here:
Children / Other Family:
Lost In:	*
Date:	*
Choose a Template:	Basic Fireman Policeman
Please write something about the deceased person, stories, hobbies, interests, their favorite things, etc...

Additional Comments:
3. Photo Upload Folder Information:
Please enter your folder name below. This will allow you to make your own Personal Upload Folder on our site. Please make sure you enter the exact folder name in the following form. Note: Your folder will be limited to 1000kb ( 1 Mb. ), only you and OKADVERTISING.NET have access to it. Please use underscores ( _ ) in place of spaces. Only .jpeg or .gif will be accepted. Example: If your Name Is OK ADVERTISING, please enter the folder name as: OK_ADVERTISING. The First and Last name of the deceased person works best.
Folder Name:	*
Picture Credits:
Date taken:
	Check here if you are sending us photos by U.S. Mail.
	Check here if you'd like your email displayed.
	Check here if you'd like your personal contact information displayed.
	Check here if you'd like a confirmation sent to your email.
Note:	Your IP Address will be logged for security purpose. Click here to see a sample.

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