Obituaries

Reba Frymoyer
B: 1928-03-13
D: 2017-10-12
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Frymoyer, Reba
Marjorie Kistler
B: 1945-04-20
D: 2017-10-09
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Kistler, Marjorie
George Leahy
B: 1933-10-09
D: 2017-10-08
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Leahy, George
Donna Gray
B: 1947-03-13
D: 2017-10-05
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Gray, Donna
Fay Rumberger
B: 1949-03-30
D: 2017-10-05
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Rumberger, Fay
William Berry, I
B: 1934-09-16
D: 2017-10-05
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Berry, I, William
Merrill Shirk
B: 1929-02-18
D: 2017-10-03
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Shirk, Merrill
Flo Apple
B: 1920-10-25
D: 2017-09-29
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Apple, Flo
Patrick Bryner
B: 1995-06-10
D: 2017-09-28
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Bryner, Patrick
Thelma Lauver
B: 1920-07-17
D: 2017-09-25
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Lauver, Thelma
Jacqueline Coder
B: 1950-10-04
D: 2017-09-23
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Coder, Jacqueline
Betty Varner
B: 1925-08-22
D: 2017-09-16
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Varner, Betty
Burnette Runkle
B: 1922-09-30
D: 2017-09-15
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Runkle, Burnette
Jeffry Hockenberry
B: 1983-05-08
D: 2017-09-15
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Hockenberry, Jeffry
Dale Hahn
B: 1954-02-05
D: 2017-09-07
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Hahn, Dale
Russell Sellers
B: 1930-09-13
D: 2017-09-06
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Sellers, Russell
Goldie Hoffman
B: 1942-05-05
D: 2017-09-04
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Hoffman, Goldie
Beatrice Hosler
B: 1920-02-12
D: 2017-08-26
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Hosler, Beatrice
Paul Peterson
B: 1956-08-18
D: 2017-08-26
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Peterson, Paul
Lawrence Rowe
B: 1937-03-20
D: 2017-08-24
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Rowe, Lawrence
Harlan Martin
B: 1964-11-04
D: 2017-08-17
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Martin, Harlan

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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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