Obituaries

Joan Elliott
B: 1939-02-16
D: 2019-02-17
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Elliott, Joan
Ryan Rymon-Lipinski
B: 1990-08-30
D: 2019-02-15
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Rymon-Lipinski, Ryan
Marvin Skirrow
B: 1932-01-01
D: 2019-02-13
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Skirrow, Marvin
Giustino Mattarelli
B: 1933-10-31
D: 2019-02-12
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Mattarelli, Giustino
Bertha Smith
B: 1927-01-05
D: 2019-02-10
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Smith, Bertha
Robert Beauregard
D: 2019-02-09
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Beauregard, Robert
Edward Willson
D: 2019-02-09
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Willson, Edward
Donald Oyston
B: 1942-05-21
D: 2019-02-08
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Oyston, Donald
Angel Marcos
B: 1942-02-10
D: 2019-02-05
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Marcos , Angel
Donald Drake
B: 1953-12-26
D: 2019-02-04
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Drake, Donald
Lea DiSimone
B: 1945-07-02
D: 2019-02-03
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DiSimone, Lea
Patrick Hunter
B: 1950-06-24
D: 2019-02-03
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Hunter, Patrick
Leo Neziol
D: 2019-02-02
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Neziol, Leo
Fiorella Gallo
B: 1955-07-08
D: 2019-02-01
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Gallo, Fiorella
Bill Gaskell
B: 1949-07-21
D: 2019-02-01
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Gaskell, Bill
Joyce Marion
B: 1931-02-14
D: 2019-01-30
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Marion, Joyce
Theresa Wenzel
B: 1928-03-05
D: 2019-01-30
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Wenzel, Theresa
Charles McCabe
D: 2019-01-29
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McCabe, Charles
Ted Feniuk
D: 2019-01-29
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Feniuk , Ted
Vera Novak
B: 1923-01-27
D: 2019-01-28
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Novak, Vera
Pasqualino Carrozzella
B: 1940-06-10
D: 2019-01-27
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Carrozzella, Pasqualino

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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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