Obituaries

Brian Jeffery
B: 1943-02-06
D: 2021-06-13
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Jeffery, Brian
Darryl Lazare
B: 1964-02-04
D: 2021-06-13
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Lazare, Darryl
Lawrence Cook
B: 1939-12-30
D: 2021-06-10
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Cook, Lawrence
John Clark
B: 1944-11-07
D: 2021-06-10
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Clark, John
Waldo Lyman
B: 1923-04-17
D: 2021-06-10
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Lyman, Waldo
Kanehkiiostha Edwards
B: 1975-07-29
D: 2021-06-09
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Edwards, Kanehkiiostha
Gordon Hazel
B: 1924-12-09
D: 2021-06-07
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Hazel, Gordon
Suzanne Wood
B: 1966-10-18
D: 2021-06-07
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Wood, Suzanne
Joellene Adams
B: 1945-04-10
D: 2021-06-02
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Adams, Joellene
Rasennes Pembleton
B: 1977-09-02
D: 2021-05-31
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Pembleton, Rasennes
Jacob Cook
B: 1954-11-11
D: 2021-05-31
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Cook, Jacob
Joseph Hillenbrand
D: 2021-05-31
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Hillenbrand, Joseph
Ilah Durant
D: 2021-05-30
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Durant, Ilah
Guy LaPointe
B: 1933-02-02
D: 2021-05-29
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LaPointe, Guy
James Hayes
B: 1991-04-13
D: 2021-05-29
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Hayes, James
Anthony VanGuilder
B: 1990-12-31
D: 2021-05-29
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VanGuilder, Anthony
Patsy Henderson
B: 1958-01-01
D: 2021-05-27
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Henderson, Patsy
Delsie Day
B: 1956-08-04
D: 2021-05-27
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Day, Delsie
Stacie Myers
B: 1970-10-25
D: 2021-05-27
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Myers, Stacie
Louise Gray
B: 1949-06-30
D: 2021-05-23
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Gray, Louise
Betty Pellegrino
B: 1931-01-19
D: 2021-05-22
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Pellegrino, Betty

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I. Biographical Information
 
Full Name:
Date of Death:
Address1:
Address2:
City Name:
State:
Zip Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
State of Birth:
Highest Education Level:
Please select Grade/Years of Education completed:
   
Social Security Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
Father's City of Residence:
Mother's Name:
Mother's City of Residence:
Mother's Maiden Name:
Spouse's Name:
Spouse's Maiden Name:
Survivors' Names and Cities of Residence
Relatives Who Have Preceded In Death
Occupation:
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted: (month/day/year)
Date of Discharge: (month/day/year)
Rank at Discharge:
Location of a Copy of Discharge (DD214):
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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