Memory Form – St. Thérèse Columbarium

Deceased Information

First Name*

Middle Name

Last Name*

Sex*

Vault Area*

Display Photo

Square (1:1) recommended

Date of Birth*

Date of Death*

Date of Inurnment*

Profile Visibility

public
private

Family Code

Submitter Details

Your Full Name

Relation to the Deceased

Email Address*

Mobile Number

Upload Valid ID

Terms of Submission:

Agree and consent to the Privacy Policy
Instruct St. Therese Columbarium to publish a memorial.
I acknowledge the right to request removal as the authorized representative.

Click here to indicate that you agree.*

I agree to the terms and conditions.