Obituaries

Brian DeGroot
B: 1971-07-22
D: 2017-09-19
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DeGroot, Brian
Diane Lotter
D: 2017-09-16
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Lotter, Diane
Dorothy Neerdaels
B: 1931-04-26
D: 2017-09-13
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Neerdaels, Dorothy
Richard Northway
B: 1940-12-18
D: 2017-09-08
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Northway, Richard
Nancy Hofkes
B: 1936-05-08
D: 2017-09-08
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Hofkes, Nancy
Donald Kuchenbecker
B: 1949-05-24
D: 2017-09-07
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Kuchenbecker, Donald
Richard Murphy
B: 1936-11-24
D: 2017-09-05
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Murphy, Richard
Marian Kiley
B: 1930-09-02
D: 2017-09-03
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Kiley, Marian
Norman McClintock
B: 1932-07-17
D: 2017-09-03
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McClintock, Norman
Dean Kennedy
B: 1953-06-21
D: 2017-08-31
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Kennedy, Dean
Eileen Longlais
B: 1922-09-08
D: 2017-08-30
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Longlais, Eileen
Peter Fleck
B: 1942-06-03
D: 2017-08-26
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Fleck, Peter
Patricia O'Neill
B: 1943-09-14
D: 2017-08-26
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O'Neill, Patricia
Lowell De Greef
B: 1945-04-15
D: 2017-08-25
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De Greef, Lowell
Judy Reinhart
B: 1930-08-10
D: 2017-08-24
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Reinhart, Judy
Darla Stephenson
B: 1951-06-28
D: 2017-08-22
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Stephenson, Darla
Florence Biegert
B: 1942-11-21
D: 2017-08-21
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Biegert, Florence
William Roebke
B: 1940-08-27
D: 2017-08-21
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Roebke, William
Rebecca Pennenberg
B: 1972-10-28
D: 2017-08-17
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Pennenberg, Rebecca
Raelia Pennenberg
B: 1999-05-06
D: 2017-08-17
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Pennenberg, Raelia
Elaine Kozlovsky
B: 1939-01-03
D: 2017-08-16
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Kozlovsky, Elaine

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860 N Webster Avenue
De Pere, WI 54115
Phone: 920-336-8702
Fax: 920-336-2150

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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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Please place my information on file

 

 

 

 

 

 

 

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