Only
names submitted on this form will be included on the *In Memoriam* list read at
the Annual Convocation of Provincial Grand Chapter.
It is with regret that this
Chapter informs you that the following Companion has passed to the Grand Lodge
above:
Please return this form to Provincial Grand
Scribe E as soon as you are aware of a Companion's death.
PLEASE MAKE SURE YOU INCLUDE
DETAILS OF NEXT OF KIN SO THAT THE PROVINCIAL GRAND ALMONER CAN MAKE
APPROPRIATE CONTACT