Obituaries

Dorothy Wiederman
B: 1943-06-22
D: 2019-05-16
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Wiederman, Dorothy
Jason Satchell
B: 1974-11-10
D: 2019-05-16
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Satchell, Jason
Nancy Dearing
B: 1955-11-26
D: 2019-05-10
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Dearing, Nancy
William Stapleton
B: 1946-08-23
D: 2019-05-09
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Stapleton, William
Keith McNairn
B: 1930-04-04
D: 2019-05-08
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McNairn, Keith
Derek Yeadon
B: 1948-07-17
D: 2019-05-07
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Yeadon, Derek
Myriam Howell
B: 1970-05-25
D: 2019-05-05
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Howell, Myriam
Evelyn Hannon
B: 1930-11-28
D: 2019-05-04
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Hannon, Evelyn
Margaret O'Reilly
B: 1933-07-27
D: 2019-04-15
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O'Reilly, Margaret
Harold Wettlaufer
B: 1926-08-27
D: 2019-04-11
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Wettlaufer, Harold
Peter Huitema
B: 1938-12-21
D: 2019-04-07
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Huitema, Peter
Jean Groenestege
B: 1928-11-09
D: 2019-04-06
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Groenestege, Jean
Matthew Diegel
B: 1984-11-03
D: 2019-04-05
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Diegel, Matthew
Theresa Kelly
B: 1927-06-02
D: 2019-03-26
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Kelly, Theresa
Clifford Bice
B: 1930-01-09
D: 2019-03-23
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Bice, Clifford
Maria Fabbricino
B: 1930-03-28
D: 2019-02-28
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Fabbricino, Maria
Ronald Elliott
B: 1959-12-17
D: 2019-02-23
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Elliott, Ronald
Murray Greene
B: 1941-07-10
D: 2019-02-20
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Greene, Murray
Johann Menzi
B: 1942-01-31
D: 2019-02-16
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Menzi, Johann
Kathy Wierenga
B: 1967-09-30
D: 2019-02-13
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Wierenga, Kathy
Beth Vosper
B: 1930-08-07
D: 2019-01-31
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Vosper, Beth

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109 Montreal Street
P.O. Box 299
Mitchell, ON N0K 1N0
Phone: 519-348-8643
Fax: 519-348-8243

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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)
City of Birth:
Province/Territory of Birth:
Highest Education Level:
Please select Grade/Years of Education completed:
   
Social Insurance 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:

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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