Obituaries

Wayne Paul
B: 1942-04-12
D: 2020-09-26
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Paul, Wayne
George Seraganian
B: 1939-02-01
D: 2020-09-24
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Seraganian, George
Charlene Schuit
B: 1952-08-09
D: 2020-09-23
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Schuit, Charlene
Janna Vermee
B: 1938-05-21
D: 2020-09-19
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Vermee, Janna
Steven Schofield
B: 1981-10-27
D: 2020-09-19
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Schofield, Steven
Rose Fitzner
B: 1939-03-04
D: 2020-09-17
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Fitzner, Rose
Murray Medlar
B: 1946-11-25
D: 2020-09-17
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Medlar, Murray
Dennis Diakun
B: 1949-11-28
D: 2020-09-16
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Diakun, Dennis
Maria DiSimone
D: 2020-09-16
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DiSimone, Maria
Margaret Harrington
B: 1927-12-24
D: 2020-09-15
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Harrington, Margaret
Nelly Seewald
D: 2020-09-14
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Seewald, Nelly
Cheryl Wood
B: 1945-03-10
D: 2020-09-13
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Wood, Cheryl
Pauline "Dolly" Woodcock
B: 1926-02-04
D: 2020-09-12
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Woodcock, Pauline "Dolly"
Deborah Crane
B: 1952-12-22
D: 2020-09-12
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Crane, Deborah
Mary Lacko
B: 1919-09-03
D: 2020-09-09
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Lacko, Mary
Carrie Pineault
B: 1978-10-22
D: 2020-09-05
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Pineault, Carrie
Carole Stoneman
B: 1939-03-12
D: 2020-09-04
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Stoneman, Carole
Diana Gray
B: 1946-04-07
D: 2020-09-03
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Gray, Diana
Donald Bonney
B: 1959-03-15
D: 2020-09-01
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Bonney, Donald
Gloria McDonald
B: 1951-11-08
D: 2020-08-29
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McDonald, Gloria
Austin Galbraith
B: 1998-11-10
D: 2020-08-29
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Galbraith, Austin

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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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