A.T. Still University

Reporting the Death of an ATSU Graduate

ATSU extends condolences to the families and friends whose loved ones have died. By reporting an alumna/alumnus death, you help us keep our records accurate and we are then able to remove their name from our mailing list.

*Required fields

Name of deceased ATSU graduate:
*First Name:
Middle Initial:
*Last Name:
Year of graduation:
Date of death:
Next of kin's name:

Spouse's name:

First Name:
Middle Initial:
Last Name:
Does the deceased have relatives that are also ATSU graduates:
Yes   No
If yes, please give names and years, if known:

Your Name:

*First Name:
Middle Initial:
*Last Name:

Your address:

Your phone number:
 .   . 
*Your e-mail address:
Your relationship to the deceased:
Please paste here the address of the link where the obituary appears on the web site:
Please provide the name of the newspaper that has the obituary:

Please note that a staff member may contact you for verification.

An obituary would be helpful, if one is available. Please fax or mail to the address below:

Alumni Relations
A.T. Still University
800 West Jefferson Street
Kirksville, MO 63501
Phone: 660.626.2307
Fax: 660.626.2970
Email: alumni@atsu.edu

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