Application – BC Law Enforcement Memorial

All applications for officer’s names to be added to the BC Law Enforcement Memorial must be received by the Foundation prior to June 1st of each year to ensure adequate time for inscription.

All applications must be accompanied by substantiating documentation wherever possible but when the application is Historical (more than one year old) news accounts, coroner’s reports, etc. are recommended.

Applications must be approved by the Chief Constable or Officer in Charge of the respective agency although the researcher should be listed as agency contact.

Agency Submitting Application

Agency name
Address
Phone

Contact Person

Name
Work Phone
Cell Phone
Email

Deceased Details

Surname
Given Name
Given Name 2
Given Name 3
Name to be Inscribed on Memorial
Marital Status
Number of Children
Funeral Type

Date of Birth
Rank
Agency
Date of Hire
Years of Official Service
Date of Death
Date of Incident Causing Death
Funeral Location

Full Details of Incident

Next of Kin

Name
Name
Name
Name
Name
Name

Relationship
Relationship
Relationship
Relationship
Relationship
Relationship

Attachments

Photograph
Substantiating Documenation

Crest of Agency