OldChesterPa: Obituary Submission Form

Please use this form if you would like to contribute an obituary for OldChesterPa.com:

* Last Name:
* First Name:
Middle Name:
Maiden Name:
Date of Death:
* Newspaper:
Date of Newspaper:	Note: Obituaries can not appear on the website until they are at least one year old. You may submit a current obituary now, but it will not appear on the site until it is at least one year old.
* Your Name:
* Your Email Address:
Email Link:	Please re-type your email address here only if you would like an email link with your name.
* Text of Obituary:	If you would like to separate the text into paragraphs, you will need to insert <br><br> at the end of each paragraph.
Notes:
Photo:	If you would like to include a photo of this individual, please attach a *.jpg to an email to me. Be sure to include the person's name and date of death in the email.

Note: Items marked with an asterisk (*) are required.

Thanks very much for your help in preserving the rich history of the city of Chester, PA!