Simple Memorial For Members

*Denotes Required Field * Title

Name of the Person Requesting the Service (አገልግሎቱን የሚጠይቀው ሰው ሙሉ ስም)

* First Name

* Last Name

* Email (ኢሜል)

* Date of Service (አገልግሎቱ የሚፈጸምበት ቀን)

* Baptismal Name of the Deceased (የሟች ክርስትና ስም)

* Phone Number (ስልክ ቁጥር) ( ) -