Form 2
Necrology and Fifty Year Member Report for State Convention (deadline: March 1)
1.	Your Name: *
2.	Your E-mail Address: *
3.	Your Council Number *
4.	ALL COUNCIL MEMBERS WHO DIED THIS YEAR --- (use semi-colon as a separator between names) -- Please indicate if the deceased member was a Bishop, Former State Chaplain, other clergy, Former State Officer, Current/Former District Deputy.
5.	50 Year Members This Past Year --- (use semi-colon as a separator between names)
6.	Your Council Position: *
7.	City of Council: *