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Funeral Notification Form
If you know of an AMFA Local 4 member who has lost a family member (Mother, Father, Spouse, Committed Partner, Child or Stepchild, Siblings, Grandparents, Grandchildren, Mother-in-law, or Father-in-law), please complete the form below so that we may honor them with flowers or a charitable donation. While we would like to honor everyone important in our members' lives, we must limit gifts to the family members specified in our Local 4 bylaws, Article 6, Section 11, Paragraph F. Please provide as much information as you can.
 
Your Name:
Your Phone #:
Members Name:
Members Loss:

Mother Father Spouse Child Step Child

Committed Partner Sister Brother Grandparents

Grandchildren  Mother-in-law  Father-in-law  
Funeral Date:

Funeral Information:

*Please provide as much

information as possible*

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6102 S. Archer Ave. #102
Chicago, IL 60638
 


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