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Obituaries

Ouida Kenney
B: 1921-11-21
D: 2018-10-21
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Kenney, Ouida
Martha Graham
B: 1934-09-02
D: 2018-10-20
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Graham, Martha
Lori Viarengo
B: 1979-02-04
D: 2018-10-20
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Viarengo, Lori
Meredith Mings
B: 1940-07-29
D: 2018-10-18
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Mings, Meredith
Wanda Eileen Jayjohn
B: 1943-07-08
D: 2018-10-18
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Jayjohn, Wanda Eileen
William Connolly
B: 1944-09-03
D: 2018-10-16
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Connolly, William
Kathryn Planthaber
B: 1954-01-20
D: 2018-10-15
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Planthaber, Kathryn
George Albury
B: 1928-08-06
D: 2018-10-15
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Albury, George
John Bishop
B: 1934-06-03
D: 2018-10-14
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Bishop, John
LaVern Fredericks
B: 1942-03-14
D: 2018-10-14
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Fredericks, LaVern
Ronald Mancini
B: 1939-06-17
D: 2018-10-12
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Mancini, Ronald
Marilyn Auriemma
B: 1929-09-17
D: 2018-10-12
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Auriemma, Marilyn
Edna Hendryx
B: 1941-09-05
D: 2018-10-12
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Hendryx, Edna
William Jarvis
B: 1956-02-15
D: 2018-10-11
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Jarvis, William
Harvey Conn
B: 1932-01-07
D: 2018-10-11
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Conn, Harvey
Martha Kry
B: 1936-04-26
D: 2018-10-09
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Kry, Martha
Joan Cail
B: 1935-01-03
D: 2018-10-09
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Cail, Joan
Elwyn Ingram
B: 1921-08-21
D: 2018-10-09
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Ingram, Elwyn
Charles John Mallue, III
B: 1947-05-04
D: 2018-10-09
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Mallue, III, Charles John
Mia Ratliff
B: 1968-05-09
D: 2018-10-08
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Ratliff, Mia
Debora Jacks
B: 1955-10-17
D: 2018-10-07
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Jacks, Debora

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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:

Miscellaneous Notes and Instructions:

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