Memorial Submission Form


In order for a deceased member of a fire department to be recognized at the West Virginia State Firemen’s Association Convention/Memorial, please fill out the following form. The Memorial Committee will be notified of the passing and will add the name to the memorial list.

Name of Deceased:
The deceased was a member of which department(s)?
Date of Death:
Your Name:
Your Email:
Your Phone:
  • Share/Bookmark