Obituaries

Christina Dumouchel
B: 1954-02-07
D: 2017-09-17
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Dumouchel, Christina
Shannon Smith
B: 1977-08-23
D: 2017-09-16
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Smith, Shannon
Randy Smith
B: 1958-07-22
D: 2017-08-26
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Smith, Randy
Hazel Williams
B: 1928-09-09
D: 2017-08-19
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Williams, Hazel
Ronald Milne
B: 1928-04-20
D: 2017-08-06
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Milne, Ronald
Suzann Thompson
B: 1939-02-01
D: 2017-07-31
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Thompson, Suzann
Michael Beven
B: 1956-11-03
D: 2017-07-27
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Beven, Michael
Luis Macedo
B: 1932-10-03
D: 2017-07-21
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Macedo, Luis
Madalene Mitchener
B: 1939-11-02
D: 2017-07-18
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Mitchener, Madalene
Murray Brandow
B: 1940-03-16
D: 2017-07-07
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Brandow, Murray
Roger Craft
B: 1939-04-08
D: 2017-07-04
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Craft, Roger
Madeline Epps
B: 1933-10-25
D: 2017-06-20
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Epps, Madeline
Donald Mawson
B: 1924-06-02
D: 2017-06-09
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Mawson, Donald
Helen Barna
B: 1932-04-21
D: 2017-06-06
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Barna, Helen
Brian Moeller
B: 1951-08-14
D: 2017-05-27
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Moeller, Brian
Margaret Rohland
B: 1932-11-23
D: 2017-05-20
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Rohland, Margaret
Robert Edgeworth
B: 1926-07-20
D: 2017-05-20
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Edgeworth, Robert
Peter Reichow
B: 1942-11-24
D: 2017-05-07
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Reichow, Peter
Preston Smith
B: 2016-10-09
D: 2017-04-11
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Smith, Preston
Cliff Collard
B: 1939-01-17
D: 2017-04-01
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Collard, Cliff
Sheila Wilson
B: 1949-06-28
D: 2017-03-20
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Wilson, Sheila

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P.O. Box 128,
Burford, ON N0E 1A0
Phone: (519) 449-1112
Fax: (519) 449-3120

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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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