Virginia Rumsey
B: 1939-08-16
D: 2016-10-21
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Rumsey, Virginia
Evelyn Betz
B: 1934-06-20
D: 2016-10-18
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Betz, Evelyn
Doris Gustafson
B: 1929-07-22
D: 2016-10-18
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Gustafson, Doris
Dominick Freeo
B: 1924-10-04
D: 2016-10-17
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Freeo, Dominick
Rodney Sisson
B: 1937-05-18
D: 2016-10-16
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Sisson, Rodney
Harry Stromberger
B: 1924-08-15
D: 2016-10-15
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Stromberger, Harry
Lorraine Feit
B: 1921-06-11
D: 2016-10-14
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Feit, Lorraine
Douglas Rice
B: 1939-08-28
D: 2016-10-13
View Details
Rice, Douglas
Dean Dale
B: 1932-10-24
D: 2016-10-10
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Dale, Dean
Gregory Schooley
B: 1946-12-21
D: 2016-10-08
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Schooley, Gregory
Wade Zeller
B: 1964-01-08
D: 2016-10-06
View Details
Zeller, Wade
Stanley Williams
B: 1932-11-06
D: 2016-10-05
View Details
Williams, Stanley
Raymond Wells
B: 1922-04-05
D: 2016-10-05
View Details
Wells, Raymond
Cleta Meyer
B: 1931-01-14
D: 2016-10-04
View Details
Meyer, Cleta
Michael Armstrong
B: 1970-10-23
D: 2016-10-03
View Details
Armstrong, Michael
Alma Raudales-Melgar
B: 1957-10-27
D: 2016-10-02
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Raudales-Melgar, Alma
Francisca Mata
B: 1939-04-18
D: 2016-10-01
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Mata, Francisca
Ron Ehrlich
B: 1942-03-02
D: 2016-10-01
View Details
Ehrlich, Ron
Michele White
B: 1963-07-01
D: 2016-09-30
View Details
White, Michele
Irma White
B: 1935-06-05
D: 2016-09-28
View Details
White, Irma
Donald Ruby
B: 1937-04-17
D: 2016-09-28
View Details
Ruby, Donald


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I. Biographical Information
Full Name:
Date of Death:
City Name:
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
Business Type:
Company Name:
Church Membership:
Lodge or Union Name:

II. Military Record
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:
Person in Charge of Arrangements:
Officiating Clergy:
Flower Preference:
Music Selection:
Casket Preference:
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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