Obituaries

Doris Rine
B: 1940-01-22
D: 2019-03-18
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Rine, Doris
Joyce Crouse
B: 1941-12-05
D: 2019-03-15
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Crouse, Joyce
Sandra Gates
B: 1937-05-18
D: 2019-03-14
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Gates, Sandra
Megan Cook
B: 1997-12-21
D: 2019-03-12
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Cook, Megan
Lester Beam
B: 1951-04-19
D: 2019-03-07
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Beam, Lester
John Rothrock
B: 1936-05-17
D: 2019-03-05
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Rothrock, John
Donald Baker
B: 1932-01-21
D: 2019-03-03
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Baker, Donald
Grace Chamberlin
B: 1934-09-14
D: 2019-03-03
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Chamberlin, Grace
Ricky Ott
B: 1961-09-12
D: 2019-03-03
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Ott, Ricky
Logan Lynch
B: 1996-12-23
D: 2019-03-03
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Lynch, Logan
Anna Kauffman
B: 1935-04-18
D: 2019-02-26
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Kauffman, Anna
John Trayer
B: 1926-03-02
D: 2019-02-23
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Trayer, John
John Shoap
B: 1922-08-16
D: 2019-02-23
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Shoap, John
Roger Green
B: 1959-11-24
D: 2019-02-23
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Green, Roger
Helen Atherton
B: 1935-05-11
D: 2019-02-22
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Atherton, Helen
Ardenia Corman
B: 1928-06-02
D: 2019-02-21
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Corman, Ardenia
Patsy Franklin
B: 1946-11-17
D: 2019-02-19
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Franklin, Patsy
Jamie Salisbury
B: 1976-01-23
D: 2019-02-18
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Salisbury, Jamie
Robert Solder
B: 1948-01-09
D: 2019-02-17
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Solder, Robert
Patricia Diehl
B: 1950-05-17
D: 2019-02-16
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Diehl, Patricia
M. Joan Kann
D: 2019-02-14
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Kann, M. Joan

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Shippensburg, PA 17257
Phone: 717-532-2211
Fax: 717-532-8471

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I. Biographical Information

Full Name:
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 You In Death
Your 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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