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Techsan Memorial Name Addition Notification

1.First Name of person to be included in the Techsan Memorial(Required.)
2.Middle Name (if applicable)
3.Last Name(Required.)
4.Phonetic Pronunciation of Name(Required.)
5.Date of Passing(Required.)
MM/DD/YYYY
6.Obituary Link (if available)
7.University status at time of passing(Required.)
8.University affiliation (College, school, dept.)
9.Notifier Contact Information(Required.)
10.Notifier Relationship(Required.)