Notice of Member Death

Deceased Member Information

On behalf of the brothers of Beta Theta Pi, please accept our deepest condolences on the loss of your family member, friend, or loved one. This survey will allow us to update his member record and inform other members of his passing.

Please provide as much information as you know about the deceased brother.

1. Full Name - First, Middle & Last Name *This question is required.

2. College/University *This question is required.

3. Birthdate This question requires a valid date format of MM/DD/YYYY.

calendar

4. Date of Death *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

If an obituary is available, please provide its online URL or upload a PDF.

5. Obituary URL

6. Obituary File Upload

File: {{filename}} delete

Country
Branch

8. Notable Lifetime Achievements

9. Parent Names

Parent 1

Parent 2

10. Marital Status

11. Spouse/Partner Name