Obituaries

John Richardson
B: 1942-11-27
D: 2019-05-30
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Richardson, John
Clinton Brockelbank
B: 1945-07-16
D: 2019-05-25
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Brockelbank, Clinton
Malcolm Rombach
B: 1944-05-05
D: 2019-05-20
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Rombach, Malcolm
"Jack" Russell
B: 1936-02-12
D: 2019-05-12
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Russell, "Jack"
Robert Webster
B: 1933-04-26
D: 2019-05-11
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Webster, Robert
Eileen Horsley
B: 1926-07-26
D: 2019-05-10
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Horsley, Eileen
Charles Brockelbank
B: 1955-03-25
D: 2019-05-04
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Brockelbank, Charles
Donald McGee
B: 1928-03-11
D: 2019-05-02
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McGee, Donald
Carol Lundsted
B: 1946-11-16
D: 2019-04-26
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Lundsted, Carol
Florence Pink
B: 1960-11-07
D: 2019-04-17
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Pink, Florence
Stanley McKechnie
B: 1933-01-21
D: 2019-04-16
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McKechnie, Stanley
Katherine Shier
B: 1958-06-01
D: 2019-04-15
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Shier, Katherine
Kendal Smith
B: 1936-04-04
D: 2019-04-12
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Smith, Kendal
Beverley Maxwell
B: 1921-01-14
D: 2019-04-11
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Maxwell, Beverley
Michael Wakeham
B: 1946-03-21
D: 2019-04-04
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Wakeham, Michael
Carman Plester
B: 1932-01-07
D: 2019-03-29
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Plester, Carman
Karen McTaggart
B: 1966-10-20
D: 2019-03-22
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McTaggart, Karen
Judy Wilson
B: 1948-03-11
D: 2019-03-21
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Wilson, Judy
Elva Phillips
B: 1926-01-26
D: 2019-03-13
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Phillips, Elva
Theresa Oelkuch
B: 1942-10-05
D: 2019-03-12
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Oelkuch, Theresa
Mary King
B: 1935-11-01
D: 2019-03-05
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King, Mary

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P.O. Box 130, 1 Highland Drive
Flesherton, ON N0C 1E0
Phone: (519) 924-2810
Fax: (519) 924-3614

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I. Biographical Information
 
Full Name:
Date of Death:
Address1:
Address2:
City Name:
Province/Territory:
Postal Code:
Telephone Number: (xxx-xxx-xxxx)
Email Address:
Date of Birth: (month/day/year)
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Social Insurance Number: For security reasons, we will contact you to complete the pre-arrangement.
Residence History:
Father's Name:
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Mother's Name:
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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:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
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Jewelry:
Glasses:
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Outer Container Preference: (for ground burial)
Cemetery Name:
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The cemetery property is in the name of:

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