Obituaries

Jerry Court
B: 1937-04-16
D: 2018-08-16
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Court, Jerry
Margaret Knettle
B: 1932-10-10
D: 2018-08-15
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Knettle, Margaret
Carol Bucci
B: 1945-05-25
D: 2018-08-14
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Bucci, Carol
Beth Lechowicz
B: 1961-01-18
D: 2018-08-14
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Lechowicz, Beth
Kenneth Smith
B: 1967-09-25
D: 2018-08-12
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Smith, Kenneth
Gordon Dailey
B: 1935-11-18
D: 2018-08-12
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Dailey, Gordon
Patricia Corry
B: 1942-09-21
D: 2018-08-10
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Corry, Patricia
Adelaide Childerhose
D: 2018-08-10
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Childerhose, Adelaide
Marjorie Rumble
B: 1935-08-20
D: 2018-08-06
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Rumble, Marjorie
Andries Dykgraaf
B: 1930-08-07
D: 2018-08-04
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Dykgraaf, Andries
Nellie Flaherty
B: 1931-05-04
D: 2018-08-02
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Flaherty, Nellie
Stella Newitt
B: 1936-05-20
D: 2018-08-01
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Newitt, Stella
Erna Hamburger
B: 1928-07-22
D: 2018-07-29
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Hamburger, Erna
Joy Wagner
B: 1950-04-30
D: 2018-07-27
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Wagner, Joy
Frank Smith
B: 1953-03-07
D: 2018-07-26
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Smith, Frank
Encarnacion Parpan-Trecapelli
B: 1965-07-31
D: 2018-07-24
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Parpan-Trecapelli, Encarnacion
Gemmima Coretti
B: 1937-12-03
D: 2018-07-23
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Coretti, Gemmima
Velvetta Gambicourt
B: 1934-02-17
D: 2018-07-22
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Gambicourt, Velvetta
Vyrtle Sisson
B: 1933-06-05
D: 2018-07-19
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Sisson, Vyrtle
Judith Daley
B: 1947-09-27
D: 2018-07-18
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Daley, Judith
Deneige Labelle
B: 1915-07-29
D: 2018-07-16
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Labelle, Deneige

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55 Charing Cross Street
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:

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