Obituary Form

Submit your webform

Obituary Submission

To submit an obituary please call (904) 249-9033 or email us at obituaries@beachesleader.com.
A representative from the paper will call you to give you a price quote and obtain payment.
Photos may be included and should be sent in a jpg format at a minimum of 225 dpi resolution. Black and white or color photos can be used, providing the picture is of good quality and not too small.

Please include only the most outstanding or notable achievements (or "high points") in the life of the person for whom the obituary is being written since space is limited.

Submitter's Name

Submitter's Email

Name and Phone Number of Person Who May be Contacted in Case More Information is Needed:

Deceased Information

Name and Age of Deceased

Residence of Deceased

Place and Time of Death (Day, Date, Time)

Services (fill out all that apply)

Funeral Date/Time

Funeral Location

Memorial Date/Time

Memorial Service Location

Who Officiated?

Organist

Soloist

Interment is Where:

Vigil Services/Rosary Services:

Officiated by Whom?

Pallbearers:

About the Deceased:

Date of Birth

Place of birth

Father's Name

Father Living or Deceased?

Mother's Maiden Name:

Mother Living or Deceased?

Name of Spouse (include maiden name, if applicable)

Spouse Living or Deceased?

If Spouse is Deceased, Date of Death

When and Where Married?

Career Information: Give a BRIEF description of occupation, education, military or other special honors:

Other Survivors? Children's Names, Names of Spouses and Where They Live, if Applicable:

Brothers and Sisters (with spouses and where they live):

Number of Grandchildren

Number of Great-Grandchildren

Number of Great-Great-Grandchildren

Preceding in Death

Memorials May Be Made To:

Name of Funeral Home in Charge of Services:

Photo

One file only.
20 MB limit.
Allowed types: gif, jpg, png.