Obituaries

Juliet Robtoy
B: 1931-01-31
D: 2017-12-12
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Robtoy, Juliet
James Ryan
B: 1951-12-01
D: 2017-12-12
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Ryan, James
Dorothy Carr
B: 1933-10-14
D: 2017-12-12
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Carr, Dorothy
Joseph Walchko
B: 1937-02-28
D: 2017-12-10
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Walchko, Joseph
Eileen Dennis
B: 1958-07-19
D: 2017-12-10
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Dennis, Eileen
Patricia Badura
B: 1926-10-26
D: 2017-12-09
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Badura, Patricia
Fonda Murray
B: 1924-10-03
D: 2017-12-09
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Murray, Fonda
R. Noella Barna
B: 1920-10-19
D: 2017-12-08
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Barna, R. Noella
Christopher Demski
B: 1981-10-29
D: 2017-12-07
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Demski, Christopher
Lillian Frew
B: 1926-12-21
D: 2017-12-05
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Frew, Lillian
Michael Fisher
B: 1969-03-17
D: 2017-12-05
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Fisher, Michael
Anita Rushlow
B: 1943-09-14
D: 2017-12-05
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Rushlow, Anita
Nancy Girouard
B: 1943-03-07
D: 2017-12-03
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Girouard, Nancy
James Benjamin
B: 1992-08-01
D: 2017-12-03
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Benjamin, James
Frank Civitelli
B: 1949-11-05
D: 2017-12-03
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Civitelli, Frank
Margaret Patterson
B: 1928-03-05
D: 2017-12-02
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Patterson, Margaret
Sharon Boulanger
B: 1962-05-27
D: 2017-12-02
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Boulanger, Sharon
Leigh Rider
B: 1939-10-30
D: 2017-12-02
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Rider, Leigh
Nelson Norman
B: 1936-09-19
D: 2017-11-29
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Norman, Nelson
Stephen Coffey
B: 1945-11-14
D: 2017-11-28
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Coffey, Stephen
Thomas Kanonas
B: 1925-08-18
D: 2017-11-25
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Kanonas, Thomas

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Phone: (860) 749-2244
Fax: (860) 763-2815

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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:

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