Galilee MBC - Report a Death

To report a death, please complete the form below.

Full Name(*)

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Phone(*)

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Address(*)

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City(*)

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State(*)

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Zip(*)

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Your Membership(*)

Member

Non-member

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Your Relationship to the Deceased(*)

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Deceased Name(*)

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Deceased Age(*)

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Deceased Membership(*)

Member

Non-member

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Funeral Home(*)

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Wake Information

Date of Wake(*)

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Time of Wake(*)

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Wake Address(*)

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City(*)

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State(*)

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Zip(*)

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Funeral Information

Date of Funeral(*)

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Time of Funeral(*)

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Funeral Address(*)

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City(*)

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State(*)

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Zip(*)

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(*)

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