Book of Remembrance

Information submitted through this form will be used in creation of the Book of Remembrance. As part of the 39th Annual New York Crime Victims Candlelight Vigil, the Book of Remembrance records the names of victims who were harmed or lost their lives to violence. The book is a tribute to those whom we love and honor. Contact information will not be included in the book, and will only be used to contact submissions if there are questions regarding the submission.

Contact details

Full name

Street address

City/town

State

Zip

(ex:12345 or 12345-1234)

Phone

(ex:999-999-9999 or 999-999-9999 x9999)

Organization you are working with:

Crime details

Victim’s name/name for Book of Remembrance

Date of crime

More details about the crime/crime victim

Email confirmation receipt

Would you like to receive a confirmation email?

Yes

No

Email