Obituaries

Dorothy Roseman
B: 1917-12-18
D: 2017-11-16
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Roseman, Dorothy
Mary Semkowicz
B: 1920-03-01
D: 2017-11-13
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Semkowicz, Mary
Edwin Thompson
B: 1945-03-30
D: 2017-11-13
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Thompson, Edwin
Amelia Stechyshyn
B: 1921-10-04
D: 2017-11-10
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Stechyshyn, Amelia
Joan Kieffer
B: 1947-11-27
D: 2017-11-09
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Kieffer, Joan
Anna Bognar
B: 1919-11-22
D: 2017-11-05
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Bognar, Anna
Pasquale DeSapio
B: 1925-03-17
D: 2017-11-05
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DeSapio, Pasquale
Margaret Cline
B: 1932-11-09
D: 2017-11-04
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Cline, Margaret
Shirley Smith
B: 1961-03-25
D: 2017-11-04
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Smith, Shirley
Helena Palynchuk
B: 1927-04-25
D: 2017-11-02
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Palynchuk, Helena
Edward Hartnett
B: 1930-12-24
D: 2017-10-31
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Hartnett, Edward
Alfreda Bodnar
B: 1921-02-28
D: 2017-10-30
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Bodnar, Alfreda
Doreen Pierroz
B: 1929-07-05
D: 2017-10-28
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Pierroz, Doreen
Catherine Seeley
B: 1936-02-21
D: 2017-10-28
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Seeley, Catherine
Anne Sutherland
B: 1928-02-08
D: 2017-10-27
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Sutherland, Anne
Stephania Rabatich
B: 1926-01-22
D: 2017-10-27
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Rabatich, Stephania
Zachary Falukozi
B: 1937-09-14
D: 2017-10-27
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Falukozi, Zachary
Vincent Downey
B: 1924-11-10
D: 2017-10-23
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Downey, Vincent
Shirley Stroud
B: 1938-01-06
D: 2017-10-22
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Stroud, Shirley
Jacques Carignan
B: 1952-07-16
D: 2017-10-22
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Carignan, Jacques
Pamela Laforme
B: 1944-12-24
D: 2017-10-21
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Laforme, Pamela

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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

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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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