ASCCP Members in Memoriam

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* 1. Please enter your contact information.

First Name:

Last Name:

Email Address:

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* 2. Please enter the information of the deceased member.

First Name:

Last Name:

Credentials:

Institution/Company:

Date Deceased:

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* 3. Please provide a brief description of the person's achievements, impact in the field, or obituary.

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* 4. If available, please upload a picture.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.