Obituaries

Charles Albright
B: 1941-07-31
D: 2017-11-11
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Albright, Charles
Harry Rothrock
B: 1924-10-16
D: 2017-11-11
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Rothrock, Harry
Betty Wade
B: 1921-07-08
D: 2017-11-02
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Wade, Betty
Ann Mills
B: 1943-05-15
D: 2017-10-31
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Mills, Ann
Nora Milliken
B: 2017-10-27
D: 2017-10-27
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Milliken, Nora
Dr. James Xanthopoulos
B: 1926-06-11
D: 2017-10-22
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Xanthopoulos, Dr. James
Barbara Baker
B: 1933-06-02
D: 2017-10-19
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Baker, Barbara
Robert Mizerek
B: 1932-01-08
D: 2017-10-18
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Mizerek, Robert
V. Eugene Metzgar
B: 1942-05-19
D: 2017-10-13
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Metzgar, V. Eugene
Jacqueline Zimmerman
B: 1926-06-16
D: 2017-10-12
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Zimmerman, Jacqueline
Vernon Ferguson
B: 1930-12-08
D: 2017-10-12
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Ferguson, Vernon
Thomas Carodiskey
B: 1947-08-19
D: 2017-10-11
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Carodiskey, Thomas
Frances Faux
B: 1920-01-23
D: 2017-09-29
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Faux, Frances
Wendy Egolf
B: 1961-05-13
D: 2017-09-25
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Egolf, Wendy
Jeffrey Sulouff
B: 1948-06-28
D: 2017-09-23
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Sulouff, Jeffrey
Frank Harpster
B: 1940-05-29
D: 2017-09-22
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Harpster, Frank
Joseph McCalips
B: 1970-02-07
D: 2017-09-22
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McCalips, Joseph
Gary McCartney
B: 1946-08-13
D: 2017-09-21
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McCartney, Gary
June Hill
B: 1926-10-12
D: 2017-09-21
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Hill, June
Peggy Moore
B: 1954-10-04
D: 2017-09-16
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Moore, Peggy
Howard Hendricks
B: 1933-04-06
D: 2017-09-16
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Hendricks, Howard

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Lewistown, PA 17044
Phone: 717-248-5486
Fax: 717-248-2277

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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:

Miscellaneous Notes and Instructions:

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