Obituaries

Marjorie Moore
B: 1932-09-05
D: 2017-08-21
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Moore , Marjorie
Debra Lawrence
B: 1956-08-14
D: 2017-08-20
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Lawrence, Debra
Carolyn Bonney
B: 1931-07-17
D: 2017-08-19
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Bonney, Carolyn
Patricia Champeon
B: 1937-07-10
D: 2017-08-17
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Champeon, Patricia
Bernard "Sonny" Bickford, CMSGT(RET)
B: 1938-07-20
D: 2017-08-17
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Bickford, CMSGT(RET), Bernard "Sonny"
Robert Milsovic, MD
B: 1937-04-30
D: 2017-08-15
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Milsovic, MD, Robert
Richard S. Dekoschak
B: 1937-01-02
D: 2017-08-15
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Dekoschak, Richard S.
Kay Travis
B: 1940-12-11
D: 2017-08-15
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Travis, Kay
Michael Butler
B: 1988-07-03
D: 2017-08-12
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Butler, Michael
Lois Ann Russell
B: 1936-01-23
D: 2017-08-11
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Russell, Lois Ann
Laura Buck
B: 1923-09-03
D: 2017-08-09
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Buck, Laura
Donald Scripture
B: 1920-06-18
D: 2017-08-09
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Scripture, Donald
Adam Yankowsky
B: 1992-06-19
D: 2017-08-07
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Yankowsky, Adam
James Moody
B: 1942-03-06
D: 2017-08-05
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Moody, James
Mary Louise Hamilton
B: 1936-03-01
D: 2017-08-04
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Hamilton, Mary Louise
Debra Calderwood
B: 1944-07-02
D: 2017-08-04
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Calderwood, Debra
Jeanne Marie Connors
B: 1954-10-22
D: 2017-07-29
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Connors, Jeanne Marie
Vaughn Chadbourne
B: 1922-07-05
D: 2017-07-29
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Chadbourne, Vaughn
Jefrey Perkins
B: 1958-04-14
D: 2017-07-28
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Perkins, Jefrey
Michael Quirk
B: 1982-10-13
D: 2017-07-28
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Quirk, Michael
Reginald Porter
B: 1942-05-03
D: 2017-07-28
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Porter, Reginald

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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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