POMC Forms
We are committed to honoring those we have lost through violence. Feel free
to browse our collection of forms for victim commemoration.
Downloadable & Online Forms
Below are the links to all the online forms available on the National POMC web site. Downloadable copies of these forms can be seen below online form.
If you would like to have your loved one’s name inscribed on a brass plate and placed on our Murder Wall…Honoring Their Memories:
Murder Wall Inscribed Plate Order Form
If you would like to have your loved one included in the Memorial Book that accompanies the Murder Wall…Honoring Their Memories:
Memorial Book Order Form
If you would like to order a photo of the individual panel that your loved one’s name was added to:
Murder Wall Panel Photo Form
If you would like to order a Personalized Individual Wall Picture in which a photograph of your loved one will be professionally superimposed on a Murder Wall panel:
Personalized Individual Wall Picture Form
If you would like to support the Murder Is Not Entertainment MINE program:
MINE Form
If you would like to initiate a Parole Block Petition:
Parole Block Program Form
If your loved one’s murderer was paroled/released early from prison:
Killer Alert Information Form
If you would like to initiate our Second Opinion Services (S.O.S.):
Second Opinion Services Form
If you would like to pay directly for recurring monthly contributions:
Debit Authorization Form
If you would like to add your loved one’s name on a POMC’s Memorial card:
Memorial Card Consent Form
National POMC
635 West 7th Street, Suite 307
Cincinnati, Ohio 45203
Email: natlpomc@pomc.org
Phone: (513) 721-5683
Fax: (513) 345-4489
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*POMC is a tax-exempt organization under the Section 501 (c)(3) of the Internal Revenue Service. Federal I.D.#31-1023437
*POMC utilizes various sources to verify all information submitted by survivors for this web site but cannot guarantee the accuracy of the data. Any similarity in names to persons living or dead is purely coincidental and unintended. Copyright and Trademark.