Obituaries

Betty Salter
B: 1934-10-24
D: 2018-04-13
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Salter, Betty
Douglas Mason
B: 1938-07-21
D: 2018-04-07
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Mason, Douglas
Brent Grattan
B: 1983-05-19
D: 2018-03-27
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Grattan, Brent
Reginald Toms
B: 1932-01-20
D: 2018-03-24
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Toms, Reginald
Velma Harper
B: 1927-04-12
D: 2018-03-21
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Harper, Velma
Joseph Royer
B: 1939-09-15
D: 2018-03-16
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Royer, Joseph
Donald Christie
B: 1940-08-11
D: 2018-03-11
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Christie, Donald
Vera Merchant
B: 1924-10-26
D: 2018-03-09
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Merchant, Vera
Vera Smith
B: 1934-08-24
D: 2018-02-22
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Smith, Vera
Andrew McCallum
B: 1937-01-07
D: 2018-02-21
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McCallum, Andrew
Edward Howard
B: 1931-09-28
D: 2018-02-18
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Howard, Edward
Ethel Seabrook
B: 1916-07-27
D: 2018-02-17
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Seabrook, Ethel
Dale Woodburn
B: 1941-09-25
D: 2018-02-16
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Woodburn, Dale
Francis Wrightman
B: 1932-04-28
D: 2018-02-14
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Wrightman, Francis
Lillian Dafoe
B: 1933-04-23
D: 2018-02-03
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Dafoe, Lillian
Laura Orloff
B: 1924-10-24
D: 2018-02-01
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Orloff, Laura
May King
B: 1925-04-11
D: 2018-01-24
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King, May
Lois Kuno
B: 1927-08-07
D: 2018-01-19
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Kuno, Lois
Terry Ferrier
B: 1956-05-11
D: 2018-01-14
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Ferrier, Terry
Kenneth Reid
B: 1949-07-08
D: 2018-01-12
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Reid, Kenneth
Gordon Bowman
B: 1951-05-21
D: 2018-01-11
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Bowman, Gordon

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PO Box 39
Havelock, ON K0L 1Z0
Phone: 705-778-2231
Fax: 705-778-2869

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I. Biographical Information
Full Name:
Date of Death:
Address1:
Address2:
City Name:
Province:
Postal Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
City of Birth:
Province 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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