Obituaries

Joyce Gray
B: 1941-09-15
D: 2018-12-13
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Gray, Joyce
Lecil Johnson
B: 1928-12-11
D: 2018-12-12
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Johnson, Lecil
Jimmy Cooper
B: 1972-01-04
D: 2018-12-06
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Cooper, Jimmy
Sherry Harris
B: 1949-01-15
D: 2018-12-02
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Harris, Sherry
Robert Vaughn
B: 1942-06-22
D: 2018-11-29
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Vaughn, Robert
Joseph Bird
B: 1953-08-23
D: 2018-11-29
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Bird, Joseph
Charles Peckham
B: 1947-03-20
D: 2018-11-29
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Peckham, Charles
Patricia Williams
B: 1935-07-24
D: 2018-11-28
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Williams, Patricia
Dwain Robinson
B: 1944-01-21
D: 2018-11-26
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Robinson, Dwain
Preston Lester
B: 1938-07-31
D: 2018-11-25
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Lester, Preston
Nancy Lawrence
B: 1924-04-07
D: 2018-11-24
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Lawrence, Nancy
Leora Easley
B: 1936-01-20
D: 2018-11-24
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Easley, Leora
Mary Hartley
B: 1931-11-05
D: 2018-11-23
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Hartley, Mary
Charles Winkle
B: 1933-10-10
D: 2018-11-20
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Winkle, Charles
Mary Tucker
B: 1936-02-08
D: 2018-11-19
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Tucker, Mary
Terry Spence
B: 1961-05-21
D: 2018-11-15
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Spence, Terry
Zana Lindley
B: 1934-08-11
D: 2018-11-14
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Lindley, Zana
Mildred Graham
B: 1941-08-26
D: 2018-11-13
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Graham, Mildred
Joe Wann
B: 1932-09-23
D: 2018-11-12
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Wann, Joe
Robert Speights
B: 1941-11-07
D: 2018-11-12
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Speights, Robert
Hazel Swann
B: 1920-05-26
D: 2018-11-06
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Swann, Hazel

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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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