By completing this form, I give permission for my data to be processed for the volunteer's database and agree that Victory Dumaguete may process personal data relating to me for personnel, administrative and/or educational purposes, make such data available as required by law.

Personal Information

Requestor's First Name *

Requestor's Last Name *

Relation to the Deceased *

Mobile Number *

First Name of Deceased *

Last Name of Deceased *

Birthdate *

Date of Death *

Date of Memorial/Interment *

Time of Memorial/Interment *

Venue of Memorial/Interment *

Is the requestor or deceased a member of Victory? *

Yes