ABOUT THE DEAD PERSON

First name*
 Last name*
Maiden name
 Nickname
Home town
 Country
Date of birth
 Gender*
Date of death*
 Hour of death (24h format)
Circumstances of death
Please provide a nice JPEG picture of the face (max 250kb)
Relationship to the submitter*
He/She was my:
       
Problems (e.g. uploading pictures)?
   

ABOUT YOU**
First name*
 Last name*
E-mail address*
 Gender*
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Personal message to Lama Ole
Personal answer to additional questions needed?
no yes
       
* mandatory field
** or person you are submitting this request for