Memorial Fund Admin Form

Welcome to Charity Smith
Please complete this form and return it to Brenda Zimmerman [email protected] In the future, changes to your contact information should be sent to [email protected] Please note that CHARITYSMITH requires up-to-date contact information for at least one fund administrator.
Date*
MM slash DD slash YYYY
Memorial Fund Name*
Memorial Fund Domain Name*
Fund Administrator Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
2nd Fund Administrator Name (optional)
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
EMERGENCY CONTACT NAME*
Email*
CAPTCHA

Welcome to Charity Smith