I would like to serve on the Advisory Board
I would like to be a member of the Support Team
I am willing to do two free eulogies a year
I am willing to donate the use of my church or facility for services
I would like to assist/donate for the cost of funeral arrangements
My funeral home is willing to work out payment plans for families that are in need
I would like to volunteer my services in assisting families in crisis by doing the
 following:

I have talked to the following individuals/churches/funeral homes, and they have indicated they would help. You can contact them at:
             
 Name/Church/Funeral Home
 Address
 Phone

Name/Church/Funeral Home
Address
Phone

Your Contact Information
Name
Address
Phone    Email              
 
Please note: The submitted information is for the exclusive use of the Harkins Community Memorial Foundation and the Rockford Park District Foundation and will not be shared or sold.