You may use this form to submit the name of a departed Rainbow member or Rainbow worker or supporter to Grand Assembly for recognition and remembrance.

  Submitter's name

  Submitter's email address

  Name of departed Sister or Brother

  Phonetic pronunciation help for name

  Departed was associated with Assembly name and number

  Date of death

add any comments in the box below
  Comments

  By checking this box, I am requesting that this departed Sister or Brother be recognized at Grand Assembly during Sessions at In Memoriam.