Obituaries

Dorothy Younker
B: 1942-12-19
D: 2019-02-22
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Younker, Dorothy
Ada Urias
B: 1933-10-09
D: 2019-02-20
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Urias, Ada
Larry Wallace
B: 1942-04-28
D: 2019-02-20
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Wallace, Larry
Dorothy Wilson
B: 1933-02-07
D: 2019-02-19
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Wilson, Dorothy
Ellen Watson
B: 1940-10-25
D: 2019-02-18
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Watson, Ellen
Connie Lloyd
B: 1960-08-17
D: 2019-02-16
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Lloyd, Connie
Mark Thrasher
B: 1960-11-03
D: 2019-02-16
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Thrasher, Mark
Philip Shaw
B: 1940-05-25
D: 2019-02-15
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Shaw, Philip
Mary Jenkins
B: 1934-03-02
D: 2019-02-15
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Jenkins, Mary
Larklyn Burke
B: 1935-07-01
D: 2019-02-15
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Burke, Larklyn
Robert Kenney
B: 1956-01-31
D: 2019-02-15
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Kenney, Robert
Linda Shifflett
B: 1954-11-29
D: 2019-02-14
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Shifflett, Linda
Peggy Riggs
B: 1947-03-10
D: 2019-02-14
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Riggs, Peggy
Leonard Morrison
B: 1948-11-02
D: 2019-02-13
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Morrison, Leonard
Arthur Marrone
B: 1958-08-25
D: 2019-02-13
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Marrone, Arthur
William Garland
B: 1973-11-03
D: 2019-02-12
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Garland , William
Ronald McGrew
B: 1946-08-05
D: 2019-02-11
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McGrew, Ronald
Peggy Myers
B: 1935-08-09
D: 2019-02-10
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Myers, Peggy
Irvin Horst
B: 1926-08-28
D: 2019-02-09
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Horst, Irvin
Mattie Starliper
B: 1929-08-30
D: 2019-02-08
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Starliper, Mattie
Lillie Ashby
B: 1937-09-20
D: 2019-02-08
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Ashby, Lillie

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Phone: 304-263-8896
Fax: 304-263-9248

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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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