Provide information in the form below to recognize your ONS colleague who has passed away.

Required Information
First Name
Last Name
Date of Death (MM/YYYY) /
Optional Information
City
State
Link to Obituary
Additional information about the member who passed away (below) will be used to assist ONS in properly identifying this member. This information will not be included in the listing on the website.
Member ID
Additional Comments


In addition to submitting this form, I would like to make a donation to the ONS Foundation in honor of my colleague.