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Obituaries

Albert Ratley
B: 1941-02-18
D: 2017-10-16
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Ratley, Albert
Arthur Permenter
B: 1936-05-11
D: 2017-10-13
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Permenter, Arthur
Ray Leurck
B: 1942-07-22
D: 2017-10-13
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Leurck, Ray
Joey Heistand
B: 1975-07-01
D: 2017-10-13
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Heistand, Joey
Linda Hawthorne
B: 1954-06-10
D: 2017-10-13
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Hawthorne, Linda
Jean Harvey
B: 1931-05-21
D: 2017-10-12
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Harvey, Jean
Ryan Boyce
B: 1991-07-04
D: 2017-10-12
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Boyce, Ryan
Michael Radomski
B: 1987-12-29
D: 2017-10-12
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Radomski, Michael
Karen Kerr
B: 1946-10-06
D: 2017-10-11
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Kerr, Karen
Helen Robbins
B: 1923-03-09
D: 2017-10-11
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Robbins, Helen
Richard Cucinotta
B: 1986-04-03
D: 2017-10-10
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Cucinotta, Richard
Theo Hollingsworth
B: 1944-09-10
D: 2017-10-09
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Hollingsworth, Theo
Charles Burton
B: 1943-01-17
D: 2017-10-09
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Burton, Charles
Judith Van Haverbeke
B: 1937-10-23
D: 2017-10-09
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Van Haverbeke, Judith
Makenzie Main
B: 2016-04-17
D: 2017-10-09
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Main, Makenzie
Nettie LaBelle
B: 1931-08-07
D: 2017-10-08
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LaBelle, Nettie
Liz Shen
B: 1964-12-03
D: 2017-10-07
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Shen, Liz
Susan Keel
B: 1957-12-19
D: 2017-10-07
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Keel, Susan
Theresa Woodhouse
B: 1958-12-24
D: 2017-10-07
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Woodhouse, Theresa
Boerner DeNike
B: 1931-05-01
D: 2017-10-07
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DeNike, Boerner
John Bell
B: 1965-08-06
D: 2017-10-07
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Bell, John

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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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