Obituaries

Ronald Mlodzik
B: 1938-03-12
D: 2017-06-21
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Mlodzik, Ronald
Albert Switalla
B: 1963-11-14
D: 2017-06-20
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Switalla, Albert
Ronald Davis
B: 1937-10-15
D: 2017-06-20
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Davis, Ronald
Charles Hilberg
B: 1942-01-27
D: 2017-06-18
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Hilberg, Charles
Raymond Mazzarelli
B: 1928-04-01
D: 2017-06-18
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Mazzarelli, Raymond
Ann Fanduzzi
B: 1921-11-15
D: 2017-06-17
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Fanduzzi, Ann
Keith Brothen
B: 1958-05-02
D: 2017-06-15
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Brothen, Keith
Richard Barnes
B: 1922-09-13
D: 2017-06-14
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Barnes, Richard
Donald Norcross
B: 1925-07-18
D: 2017-06-13
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Norcross, Donald
Lay Handford
B: 1955-05-20
D: 2017-06-11
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Handford, Lay
Robert Wagnon
B: 1928-12-29
D: 2017-06-08
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Wagnon, Robert
Andrew Mastronardi
B: 1934-09-12
D: 2017-06-06
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Mastronardi, Andrew
Florence Wesselius
B: 1922-04-27
D: 2017-06-02
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Wesselius, Florence
Heidi Schuerstedt
B: 1963-03-01
D: 2017-06-01
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Schuerstedt, Heidi
Mildred Aken
B: 1939-02-07
D: 2017-05-29
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Aken, Mildred
Richard Arnold
B: 1955-08-01
D: 2017-05-29
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Arnold, Richard
Rexanna Adasiak
B: 1955-06-02
D: 2017-05-28
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Adasiak, Rexanna
Sharon Bello
B: 1939-08-16
D: 2017-05-28
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Bello, Sharon
Kathleen Haller
B: 1944-11-13
D: 2017-05-24
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Haller, Kathleen
Calvin Gardinier
B: 1932-09-08
D: 2017-05-21
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Gardinier, Calvin
Kristine Barnes
B: 1963-10-14
D: 2017-05-15
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Barnes, Kristine

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Kenosha, WI 53144
Phone: (262) 654-3533
Fax: (262) 654-3539

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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:

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