True and Fascinating Canadian History

The 140TH Anniversary Of Canada's National Police Force

1873 - 2013

Reg.#49314



PLEASE FILL OUT THE FORM BELOW TO SEND DETAILS
ABOUT A DECEASED MEMBER OF THE FORCE.

Not every space has to be complete for transmission.

Buffalo Joe will process your information and enter it into the database.

Scroll down to the bottom of the page and click 'SUBMIT'


ENTER DATES IN CANADIAN FORM: (DAY then MONTH then YEAR)

EXAMPLE: 24/10/2013



Your Email:

Your Name:

Comments or Feedback:

If you have any other information about a deceased member, please fill out the following with any information you can provide:

Deceased Name: (Last Name, First Name(s)):

Regimental Number:

Officer Number:

Other Number(s):

Rank:

Designation: (NWMP, RNWMP, RCMP/GRC):

Join Date: (dd/mm/yyyy):
EXAMPLE: 04/10/1944 (day/month/year)

Retirement Date: (dd/mm/yyyy):
EXAMPLE: 24/10/1944 (day/month/year)

Other Police Service:

Divisions/Provinces Served:

Birth Date: (dd/mm/yyyy):
EXAMPLE: 19/11/1964 (day/month/year)

Birth Place:

Death Date: (dd/mm/yyyy):
EXAMPLE: 24/10/1964 (day/month/year)

Place Of Death:

Cemetery Name:

City:

Prov/State: (ON for Ontario):

Country (CA for Canada):

GPS Coordinates:

Condition of Grave:
(ie: good, or poor and needs restoration)

Notes: Re: Grave:
(ie: Marker does or does not have the Crest of the Force, or,
the Crest has faded)

Grave Inspection Date: (dd/mm/yyyy):
EXAMPLE: 24/10/2012 (day/monthyear)

Died while Serving: (Yes/No):

Honours/Medals:

Military Services: (WWI, WWII or other,
specify: ie: Korea, Viet Nam):






Mountie










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