In Memoriam Announcement
Deceased's First Name
Deceased's Middle Name
Deceased's Last Name
Suffix
Maiden Name
(if applicable)
Date of Birth
(mm/dd/yyyy)
Date of Death
(mm/dd/yyyy)
Affiliation with HBA
(check all that apply)
HBA Alum
HBA Faculty/Staff Member
MAC Member
TAC Member
HBA Graduation Year
In Memoriam Announcement
(Limit of 600 words)
Attach a Photo: If you would like to include a photo with your announcement, please attach a photo. The photo must be a head and shoulder shot of the deceased ONLY and of high resolution (1 MB).
Attach File
Max file size: 10 MB
Release
Do you release this announcement and photo for possible publication in the HBA Soaring Eagle?
Yes
No
Digital Signature*
You agree and consent that your use of a key pad, mouse or other device to select an item, button, icon, checkbox, to enter text, or to perform a similar act/action (e.g., by clicking “Submit”) constitutes your electronic signature and signifies your intent to be bound. You understand that your electronic signature is legally binding, just as if you manually signed a paper document in ink.
Yes
No
Your First Name
Your Last Name
Address 1
Address 2
City
State
Zip
Country
Phone
Please send a confirmation email to the address below*: