Obituaries

Holly Quillen
D: 2018-09-18
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Quillen, Holly
Randy Lewis
D: 2018-09-17
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Lewis, Randy
Jennifer Malone
B: 1971-12-18
D: 2018-09-15
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Malone, Jennifer
Gregory Burham
D: 2018-09-14
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Burham, Gregory
Verna Lange
B: 1930-06-21
D: 2018-09-14
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Lange, Verna
Judith Spores
B: 1942-01-28
D: 2018-09-13
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Spores, Judith
Virginia Enman
D: 2018-09-13
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Enman, Virginia
James Gilchrist
D: 2018-09-13
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Gilchrist, James
Nick Youngkin
B: 1951-02-06
D: 2018-09-13
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Youngkin, Nick
Malcolm Sippy
D: 2018-09-12
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Sippy, Malcolm
Mary Hayes
B: 1927-07-26
D: 2018-09-12
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Hayes, Mary
Anita Leiter
D: 2018-09-08
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Leiter, Anita
Barbara Mast
B: 1939-04-30
D: 2018-09-07
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Mast, Barbara
Jarrod Tippens
D: 2018-09-07
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Tippens, Jarrod
Joseph Pepe
B: 1938-02-01
D: 2018-09-06
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Pepe, Joseph
Bradley Tudahl
B: 1984-08-31
D: 2018-09-06
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Tudahl, Bradley
Rosina Wallender
D: 2018-09-06
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Wallender, Rosina
Susan Prichard
D: 2018-09-04
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Prichard, Susan
Frederick Bauman
B: 1955-10-19
D: 2018-09-04
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Bauman, Frederick
Travis Dishman
B: 1984-04-02
D: 2018-09-03
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Dishman, Travis
Eva Bond
B: 1924-02-24
D: 2018-09-02
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Bond, Eva

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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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