Memorial Submission Form

The District Attorney’s office is welcoming those who have lost a loved one to drugs to share a memorial remembering the person they’ve lost. In the battle against opioid addiction, I believe part of the solution is fighting this with a unified community approach. Part of this approach is remembering those we’ve lost to this horrible disease. I’d like to continue to fight this disease by showing the sons, daughters, brothers, sisters and parents we’ve lost through pictures of them when they were at their best on a Memorial Wall. The goal of the Memorial Wall is to show people that this isn’t a moral failing, but a chronic disease. We need to remember those we’ve lost with compassion to help remove the stigma and open the doors to treatment. Please use this space to share your loved one’s story and your memories of them.

Memorial Information
Name*
First Last
Birth Date*
MM slash DD slash YYYY
City or town in Worcester County*
Date of passing*
MM slash DD slash YYYY
Your Memorial*
Your Information
Name*
First Last
Email*
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Relationship to the deceased*
Subtmit a photo*
Max. file size: 256 MB.
I would like my loved one’s memorial to be included on District Attorney Early’s website memorial*
- Yes
- No
I would like my loved one’s memorial to be included on District Attorney Early's Memorial Wall and video presentation*
- Yes
- No
I would like my loved one's memorial to be included on District Attorney Early's social media and promotional materials*
- Yes
- No
Disclaimer
Due to the sensitive nature of these submissions, all memorials will be approved by the District Attorney’s office before being posted on the website to ensure that there is no improper language or disrespectful remarks. This may take up to three business days. Thank you.

Memorial Submission Form

Memorial Information

Your Information

Disclaimer

Share