Obituaries

Leslie Waltman
B: 1942-12-29
D: 2019-05-19
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Waltman, Leslie
Charles Miller Sr.
B: 1923-01-18
D: 2019-05-17
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Miller Sr., Charles
Helen Cole
B: 1925-02-14
D: 2019-05-11
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Cole, Helen
Thelma Moore
B: 1920-10-07
D: 2019-05-08
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Moore, Thelma
Georgia Malone
D: 2019-05-08
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Malone, Georgia
Pamela Janecek
B: 1956-06-08
D: 2019-05-05
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Janecek, Pamela
Rita Dilport
B: 1947-11-23
D: 2019-05-01
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Dilport, Rita
Daniel Montgomery
B: 1946-09-29
D: 2019-05-01
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Montgomery, Daniel
Richard Lake
D: 2019-04-24
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Lake, Richard
Ronald Lashley
B: 1940-01-29
D: 2019-04-24
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Lashley, Ronald
Elizabeth Bridges
B: 1940-10-30
D: 2019-04-22
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Bridges, Elizabeth
Michael Johnson
B: 1965-01-06
D: 2019-04-14
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Johnson, Michael
Joan Mensing
B: 1962-01-30
D: 2019-04-10
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Mensing, Joan
Maybel Miller
B: 1924-10-26
D: 2019-04-10
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Miller, Maybel
Joan Dungan
B: 1935-06-19
D: 2019-04-08
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Dungan, Joan
Kenneth Hicks
B: 1932-03-05
D: 2019-04-06
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Hicks, Kenneth
Owen Brown
B: 1943-08-28
D: 2019-04-01
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Brown, Owen
Dana Taylor
B: 1971-10-21
D: 2019-03-31
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Taylor, Dana
Dorothy McLain
D: 2019-03-25
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McLain, Dorothy
Paul Pigg
B: 1923-01-10
D: 2019-03-20
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Pigg, Paul
Bernard Wheelehon
B: 1933-11-18
D: 2019-03-17
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Wheelehon, Bernard

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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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