Obituaries

William Poechman
B: 1940-10-04
D: 2019-05-21
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Poechman, William
David Bellamy
B: 1953-03-30
D: 2019-05-19
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Bellamy, David
Wayne Arnold
B: 1949-01-08
D: 2019-05-18
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Arnold, Wayne
Sam MacDonald
B: 1948-06-21
D: 2019-05-13
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MacDonald, Sam
Walter George
B: 1928-09-01
D: 2019-05-11
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George, Walter
John Clark
B: 1948-10-13
D: 2019-05-10
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Clark, John
Peter Fritz
B: 1949-08-18
D: 2019-05-10
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Fritz, Peter
Gretta Williams
B: 1938-03-16
D: 2019-05-06
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Williams, Gretta
Elizabeth Millen
B: 1949-03-20
D: 2019-05-05
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Millen, Elizabeth
John Thompson
B: 1944-02-21
D: 2019-04-25
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Thompson, John
Darlene Schefter
B: 1938-04-18
D: 2019-04-19
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Schefter, Darlene
Tamara Watson
B: 1993-05-28
D: 2019-04-07
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Watson, Tamara
Thelma Webb
B: 1930-04-13
D: 2019-04-04
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Webb, Thelma
Laura Dredge
B: 1953-03-02
D: 2019-04-04
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Dredge, Laura
Stephanie Cronier
B: 1987-04-07
D: 2019-04-04
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Cronier, Stephanie
Marjorie Kempel
B: 1943-04-15
D: 2019-04-02
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Kempel, Marjorie
Robert Goulding
B: 1945-10-15
D: 2019-03-29
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Goulding, Robert
Bruce Macpherson
B: 1931-07-31
D: 2019-03-28
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Macpherson, Bruce
James Schnurr
B: 1935-09-14
D: 2019-03-26
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Schnurr, James
Marjorie Matthews
B: 1931-01-09
D: 2019-03-24
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Matthews, Marjorie
Mary Nielissen
B: 1935-09-24
D: 2019-03-21
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Nielissen, Mary

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Box 69
Walkerton, ON N0G 2V0
Phone: 519-881-1273
Fax: 519-881-3382

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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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