Dakota Conference

Obituary Reporting

Name of Deceased

Date of Birth

Place of Birth

Date of Death

Place of Death

Church Membership

Copy of obituary sent to Conference Office?

Yes No

Contact Info

Name of person reporting

Contact info of person reporting

Related Information

Forms Camp Registration Campmeeting Registration Change of Address Church Supply Order Form Dirt Kicker Run Registration Men's Retreat Registration New Member Reporting Women's Retreat Registration