Ontario Professional Fire Fighters Association
Ontario Professional Fire Fighters Association
 

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First Name of Deceased *
Last Name of Deceased *
Municipality *
Rank *
Age *
Date of Death *
Cause of Death *
WSIB Number *
WSIB Confirmation Letter *
Claim Accepted *
Wall Display
Please indicate how you would like the name to be displayed on the wall. Include the name, Year of Death, Municipality, and Rank. For example: JON DOE | 2025 TORONTO CAPTAIN. Important Information: Due to limited space on the Memorial Wall, all new additions will include only the individual's first and last name. Ranks will also be simplified; for example, "First Class Firefighter" will be listed as "Firefighter." We kindly ask for everyone's understanding and cooperation as we work to accommodate future additions to the Memorial Wall. If you have a specific request or require special consideration, please contact us at admin@ontariofirefighters.org, and we will do our best to accommodate your request.

KIN INFORMATION

Please ensure that the family’s contact information is accurate and up to date, as invitations will be sent by email and regular mail using the information provided below.

Next of Kin First Name *
Next of Kin Last Name *
Next of Kin Address *
Address 2
City *
Province *
Postal Code *
E-mail Address *
Please provide the email address of a family member or friend to receive information regarding the memorial.
Next of Kin Phone Number *
Children of Deceased (if known) *

YOUR INFORMATION

Please note that you will be contacted to confirm the correct spelling of the name and will also be copied on the emails sent to the family.

Your Organization's Name
Your Fire Chief's First Name
Your Fire Chief's Last Name
Your First Name *
Your Last Name *
Your Title *
Your Address *
Address 2
City *
Province *
Postal Code *
Your Phone Number *
Your Email Address *
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