Death Report Form

We invite you to use this form to report the passing of an enrolled student, faculty, academic or staff member.

We use this information to ensure we recognize departed community members in a Remembrance Ceremony. Your contribution helps ensure we pay tribute to every cherished life. We are accepting names for the 2025 Remembrance Ceremony of affiliated individuals who passed away between May 1, 2024 and April 30, 2025.

Information about the deceased

Title

First

Middle

Last

Date of Death (06/01/23 – 04/30/24)

The Deceased was:

Division/Unit/Department

Job Title (if applicable)

Your name

Relationship to the Deceased

What is your preferred communication method?

phone

Phone

Do not fill out this field