Obituaries

Susan Hollowell
B: 1964-09-03
D: 2017-10-20
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Hollowell, Susan
Pauline Winter
B: 1944-02-05
D: 2017-10-19
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Winter, Pauline
Delmer Males
B: 1940-11-28
D: 2017-10-19
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Males, Delmer
Kenneth Vajtku
B: 1964-05-30
D: 2017-10-18
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Vajtku, Kenneth
Betty McPhee
B: 1931-03-17
D: 2017-10-17
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McPhee, Betty
Samiram Gobelian
B: 1915-09-10
D: 2017-10-16
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Gobelian, Samiram
John McGarrity
B: 1943-12-31
D: 2017-10-15
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McGarrity, John
Lillian Putt
B: 1930-07-26
D: 2017-10-14
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Putt, Lillian
Florence Homeniuk
B: 1933-01-24
D: 2017-10-14
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Homeniuk, Florence
Daryl Bailey
B: 1951-03-23
D: 2017-10-11
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Bailey, Daryl
Nancy Richards
B: 1954-02-19
D: 2017-10-11
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Richards, Nancy
Katharina Wiebe
B: 1928-07-23
D: 2017-10-07
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Wiebe, Katharina
Lillian Edwards
B: 1923-09-04
D: 2017-10-06
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Edwards, Lillian
William McPherson
B: 1957-12-14
D: 2017-10-05
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McPherson, William
Jean DeGraaf
B: 1931-12-25
D: 2017-10-03
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DeGraaf, Jean
Marion Roberts
B: 1944-09-26
D: 2017-10-01
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Roberts, Marion
William Patterson
B: 1945-06-17
D: 2017-09-29
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Patterson, William
Audrey Detheridge
B: 1923-08-05
D: 2017-09-29
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Detheridge, Audrey
Anna Byron
B: 1932-09-18
D: 2017-09-29
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Byron, Anna
Betty Holmes
B: 1930-01-07
D: 2017-09-29
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Holmes, Betty
Pierre Cazabon
B: 1971-09-07
D: 2017-09-25
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Cazabon, Pierre

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Brantford, ON N3R 2H4
Phone: (519) 753-8655
Fax: (519) 753-1195

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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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