Obituaries

Mario Lucente
B: 1925-05-28
D: 2018-05-13
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Lucente, Mario
Apolonia Betlejemski
B: 1927-08-16
D: 2018-05-10
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Betlejemski, Apolonia
George Ward
B: 1950-08-17
D: 2018-05-10
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Ward, George
Kathleen Milne
B: 1965-04-21
D: 2018-05-09
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Milne, Kathleen
Franciszek Rojek
D: 2018-05-07
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Rojek, Franciszek
Chris Toelly
B: 1986-10-21
D: 2018-05-05
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Toelly, Chris
Ronald Wratten
B: 1933-04-30
D: 2018-05-04
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Wratten, Ronald
Isaac Pereira
B: 1949-06-08
D: 2018-05-02
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Pereira, Isaac
Joan Fink
B: 1933-06-10
D: 2018-04-30
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Fink, Joan
Olga Green
B: 1919-09-02
D: 2018-04-30
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Green, Olga
Joseph Hodges
B: 1941-10-07
D: 2018-04-27
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Hodges, Joseph
Shirley Soltau
B: 1939-04-17
D: 2018-04-23
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Soltau, Shirley
Russell Thoman
B: 1932-04-08
D: 2018-04-22
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Thoman , Russell
Louise Wills
B: 1953-02-21
D: 2018-04-22
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Wills, Louise
Vincenza Gallucci
B: 1932-03-11
D: 2018-04-19
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Gallucci, Vincenza
William Scott
B: 1948-12-02
D: 2018-04-19
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Scott, William
Debara Macdonald
B: 1954-08-10
D: 2018-04-18
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Macdonald, Debara
Vincenzo Di Nino
B: 1936-02-18
D: 2018-04-17
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Di Nino, Vincenzo
Charles Barsony
B: 1933-08-25
D: 2018-04-16
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Barsony, Charles
Vincent Duff
D: 2018-04-16
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Duff, Vincent
Molly Frederiksen
B: 1933-11-26
D: 2018-04-16
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Frederiksen, Molly

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Phone: (519) 753-8655
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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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