In Memoriam Authorization Form

To respect the memory of the RTAM who have passed, family members are welcome to provide their authorization to have their loved ones name shared with the RTAM community.

Fields marked with an * are required.

Name of Deceased RTAM Member *

Please provide the name (legal first and last name and preferred name) of your loved one.

*Note: Confirmation of membership will be verified by the RTAM office.

Member's Date of Passing *

Please share the date of passing of your loved one.

Last Known Location of Deceased RTAM Member *

Please share the City/Town, Province/State and Country where your family member resided, or they resided the longest.

Name and Relationship of Family Member *

Please share your name and relationship with us.

Email *

If the RTAM office has any questions regarding the In Memoriam request you have submitted, they will reach out to you by email.

RTAM Member Pre-authorization

If you would like to pre-authorize RTAM to include your name and last known location in any RTAM In Memoriam notifications, please complete this section, with the following information:

Your first and last name
Your preferred first name
You last known City/Town, Prov/State and Country of Residence

**Those who are current RTAM members, up to the time of passing, will be included in the In Memoriam.

Authoriztion *

I authorize that the information is true and that RTAM may list the name and location of my loved one in future communications with its membership.

Please verify that you have checked the “I'm not a robot” checkbox.