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Obituary Submission Form

This form can be used to submit an obituary publication request for publication in the Canby Herald, Molalla Pioneer and/or Wilsonville Spokesman Newspapers.

IMPORTANT INFORMATION Please note: Each submittal must have a contact name and telephone number where we can verify the information before publication. If we are unable to verify the information we will be unable to publish the information.

Name and age of the deceased:

Gender:

Male: Female:

Enter the date of death:

Place and cause of death:

Enter the date of birth:

Where was the deceased born?

Parents names:

Please supply a brief summary of schooling, and early life of the deceased:

Please supply the date and place of the marriage and the spouse's name/maiden name:

Brief summary of career, military service and other important events in the deceased person's life:

What organizations, churches, civic groups did the deceased belong to?

Survivors (immediate family only). List hometown of each please. Please Note: List grandchildren, great-grandchildren, nieces, etc. by number only. i.e. "13 grandchildren".

Please supply the date, time and place of services for the deceased

Minister officiating:

Place of burial:

Name and phone number of the funeral home in charge

Memorial contributions to?

Also publish announcement in:

 Molalla Pioneer: Canby Herald:

Contact Name:

Email Address:

Contact Phone:

Work Phone:

Please provide a name and number of someone that we can contact to verify this information and/or questions. PLEASE NOTE: THIS IS A REQUIRED FIELD AND MUST BE FILLED IN FOR PUBLICATION.

Pictures are welcome and can be e-mailed to spokesman@wilsonvillespokesman.com or they can be dropped off or mailed with a copy of this form and a self addressed return envelope to the Wilsonville Spokesman, 241 N. Grant St., Canby, OR 97013. If you have any question you can call the Wilsonville Spokesman at 503-682-3935.