Pre-Authorization for In Memoriam

As an RTAM member, you are now able to provide us your pre-authorization to include your name in the In Memoriam list in KIT. 

Fields marked with an * are required.

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

Please list your name, as you would like it to appear in the RTAM In Memoriam. 

Please provide your current location, or the location that you would prefer to appear in the In Memoriam.

Please list the name of your next of kin, so that RTAM can share the In Memoriam with them, once you have passed. 

Please provide the email for your next of kin, so the RTAM office can communicate and share the In Memoriam with them in the future. If the email changes for the next of kin, please remind them to connect with the RTAM office, to have the information updated. 

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