Request to Submit to
MADD Ohio's Online Memorials
To include your loved one in our on-line memorial,
your request must be received in writing.
NOTE: You may fill in this form before printing
or print the page and complete later.
We cannot honor your request without your signature.
PLEASE INCLUDE A PHOTO OF YOUR LOVED ONE
WITH THEIR NAME WRITTEN ON THE BACK.
IF YOU WOULD LIKE YOUR PHOTO RETURNED,
PLEASE INCLUDE A SELF-ADDRESSED STAMPED ENVELOPE.
MADD is not responsible for any errors or omissions in the information supplied by the victims' families. By submitting information for inclusion in the online memorial, you acknowledge that the information may be reproduced, republished, altered or rebroadcast by parties who visit the site. Other individuals or organizations may link their Internet sites to the site. Such linking may be accomplished without MADD's prior knowledge or authorization. By signing, you agree that MADD is not responsible for any errors, alterations or damage to such information or for the use of any such information or material by anyone accessing or linking to the memorial site.
Mail entire completed form to:
MADD Ohio
5900 Roche Drive, Suite 250
Columbus, Ohio 43229-3277
* MADD reserves the right to edit messages to conform to length and space constraints.
** If you are entering your message before printing and the scrollbar appears, only the text showing in the textbox will be printed. (There is ample space in the textbox for a 100 word message).
*** MADD members who already have a memorial online may submit their messages using this form (please complete the form so that your message is attributed to the proper memorial).
Check here if your memorial is presently online.