KSFFA Memorial Service Name Submittal Form

Submitting names for Memorial Service at Annual KSFFA/KSFFAA Conference


First THANK YOU! To everyone that sent me names, pictures and information for the memorial service. Please continue to send any of the following information concerning the death of a firefighter, retired, off duty, or in the line of duty.

 

NAME_______________________________________________________________________________________________________________

 

Fire Department_____________________________________________________________________________________________________

 

Years OF SERVICE____________________________________________________________________________________________________

 

POSITION IN DEPARTMENT____________________________________________________________________________________________

 

DATE OF DEATH________________________________________________________________________________________________________

 

DATE OF BIRTH (if available)____________________________________________________________________________________________

 

If a picture of the deceased is available, and/or an address for the family, it would be very welcomed and used only for the memorial service and support the family. Again, thank you for any assistance you are able to offer.

 

My e-mail address is dapitts@turnkeymail.com and my mailing address is Donna Pittaway, Auxiliary Chaplain, 2206 S. 29th Street, Kansas City, Kansas 66106