Obituaries

Marion Larson
B: 1915-07-09
D: 2017-11-21
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Larson, Marion
Wayne Heath
B: 1942-02-04
D: 2017-11-21
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Heath, Wayne
Gloria L. Leonard
B: 1938-06-18
D: 2017-11-18
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Leonard, Gloria L.
Brenda Shannon
B: 1962-11-02
D: 2017-11-17
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Shannon, Brenda
Harold John Hopkins
B: 1965-07-27
D: 2017-11-17
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Hopkins, Harold John
George Wallace
B: 1931-12-19
D: 2017-11-14
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Wallace, George
Allen B. Lovelette
B: 1932-03-31
D: 2017-11-14
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Lovelette, Allen B.
Gertrude 'Trudi' Lichtman
B: 1927-05-24
D: 2017-11-14
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Lichtman, Gertrude 'Trudi'
Lucille Higgins
B: 1948-11-06
D: 2017-11-14
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Higgins, Lucille
Janice Mitchell
B: 1933-08-09
D: 2017-11-14
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Mitchell, Janice
Carlton Edgecomb
B: 1950-06-25
D: 2017-11-14
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Edgecomb, Carlton
Carlyle Coutts
B: 1929-02-23
D: 2017-11-14
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Coutts, Carlyle
William Anderson
B: 1925-07-18
D: 2017-11-13
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Anderson, William
Phyllis Rhoads
B: 1925-03-04
D: 2017-11-13
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Rhoads, Phyllis
Amy Nolan
B: 1980-07-25
D: 2017-11-08
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Nolan, Amy
Donna Marie King
B: 1947-03-25
D: 2017-11-07
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King, Donna Marie
Lloyd E. Willey
B: 1934-09-19
D: 2017-11-06
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Willey, Lloyd E.
Paul Phillips
B: 1964-04-11
D: 2017-11-06
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Phillips, Paul
William Lawlor
B: 1924-08-27
D: 2017-11-04
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Lawlor, William
Richard Philippon
B: 1959-02-26
D: 2017-11-04
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Philippon, Richard
Leo Hamel
B: 1930-02-01
D: 2017-11-02
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Hamel, Leo

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I. Biographical Information
Full Name:
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 You In Death            
Your 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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