Funeral Announcement Submission form

Discover Moose Jaw

800 CHAB

Submit your announcement below. Your announcement will be aired on CHAB. It will also be posted on DiscoverMooseJaw.com.

Personal Info

Name of deceased(Required)

First Last

Name Pronunciation

Age(Required)

Address(Required)

Formerly Of

Date of Death(Required)

MM slash DD slash YYYY

Location of Death(Required)

Immediate Survivors(Required)

Predeceased by(Required)

Funeral Arrangements (Check all that apply)(Required)

Mass of Resurrection

Cremation has taken place

Funeral Service

Pending

Memorial Service

Celebration of Life

Other

If Other, please describe

Service Date

Service Date

MM slash DD slash YYYY

Service Time

Hours

:

Minutes

AM/PM

Service Location

Funeral Service Details

Choose One(Required)

Burial

Ash interment

Other

N/A

Burial or Ash Interment Location

Prayer Service(Required)

Prayer Service Date(Required)

MM slash DD slash YYYY

Prayer Service Time(Required)

Hours

:

Minutes

AM/PM

Prayer Service Location(Required)

Viewing(Required)

Viewing Date(Required)

MM slash DD slash YYYY

Viewing Start Time(Required)

Hours

:

Minutes

AM/PM

Viewing End Time

Hours

:

Minutes

AM/PM

Viewing Location(Required)

Viewing Prior to the Service(Required)

Viewing Prior to the Service Location(Required)

Donations can be made to

Donations can be made to a charity of one’s choice

Donations can be made to a charity of one’s choice

Funeral Home in charge of arrangements(Required)

Family Tribute (for online posting only)

Contact Info

Your Name(Required)

First Last

Your Phone Number(Required)

Your Email(Required)

Enter Email Confirm Email

Billing

The cost per announcement is $100.00 + GST.

Once your payment has been received, your announcement will be read on CHAB for the selected number of days. It will also be posted on DiscoverMooseJaw.com.

Payment(Required)

Dates you wish your announcement to air(Required)

Announcement Photo (Optional)

Max. file size: 64 MB.

Consent(Required)

I agree to allow Golden West to contact me using this information. View Privacy details.

Total Amount (including GST)

Funeral Announcement Submitter

Funeral Announcement Submitter(Required)

I'm a funeral home submitting this announcement - please send me an invoice.

I'm an individual submitting this announcement - I will submit payment now (required for non-funeral homes).

Name of Funeral Home - for invoice purposes(Required)

Credit Card

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