Obituaries

William Camp
B: 1927-09-02
D: 2018-11-18
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Camp, William
Eileen Michalewicz
B: 1921-06-05
D: 2018-11-18
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Michalewicz, Eileen
Arthur Archambault
B: 1937-06-22
D: 2018-11-17
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Archambault, Arthur
William Crosby
B: 1930-11-12
D: 2018-11-15
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Crosby, William
Steven Portuese
B: 1956-05-10
D: 2018-11-14
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Portuese, Steven
Edward Golon
B: 1923-10-02
D: 2018-11-13
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Golon, Edward
Leonard Percoski
B: 1940-12-02
D: 2018-11-13
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Percoski, Leonard
Paul Wagner
B: 1952-12-17
D: 2018-11-09
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Wagner, Paul
Judith Brewster
B: 1934-11-20
D: 2018-11-09
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Brewster, Judith
Teresa Gallerani
B: 1930-02-05
D: 2018-11-08
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Gallerani, Teresa
Walter Bednaz
B: 1924-12-20
D: 2018-11-07
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Bednaz, Walter
Mildred Barend
B: 1938-08-23
D: 2018-11-06
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Barend, Mildred
Willard Koropatkin
B: 1923-07-28
D: 2018-11-06
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Koropatkin, Willard
Ashley Locke
B: 1990-11-01
D: 2018-11-06
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Locke, Ashley
Richard Hamilton
B: 1946-05-05
D: 2018-11-01
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Hamilton, Richard
Jenet Hijeck
B: 1929-06-12
D: 2018-10-31
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Hijeck, Jenet
Louise Vujs
B: 1940-03-06
D: 2018-10-31
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Vujs, Louise
Paul Roy
B: 1935-10-04
D: 2018-10-30
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Roy, Paul
Lois Tetro
B: 1930-03-31
D: 2018-10-30
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Tetro, Lois
Mary Ridel
B: 1958-01-31
D: 2018-10-29
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Ridel, Mary
Howard Grue
B: 1930-10-10
D: 2018-10-24
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Grue, Howard

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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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