Family Member Form
First Name

Family Surname
Middle Name
Other Names
(Optional) Do you have any nicknames or a name in another language?
(Optional: Lunar Birthday)
When did this person pass away?
Hometown, State, Country
Current Address
Please include street address, unit #, city, province/state, country and postal/zip code.
Phone Number
What's the best number to reach you by phone? (Please include country code)
Profile Photo
Please upload a recent photo of yourself!
Add image
Additional Info
Examples: social media handles, miscellaneous details

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