Obituaries

Donnita Dashnea
B: 1951-05-12
D: 2017-05-20
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Dashnea, Donnita
Harold Ducharme
B: 1935-01-06
D: 2017-05-20
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Ducharme, Harold
Glen Shaner
B: 1952-05-25
D: 2017-05-18
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Shaner, Glen
Rodney Davis
B: 1967-09-30
D: 2017-05-17
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Davis, Rodney
Marie Kenmille
B: 1945-07-12
D: 2017-05-17
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Kenmille, Marie
Kay Witham
B: 1933-12-11
D: 2017-05-16
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Witham, Kay
Lillian Pablo
B: 1927-01-23
D: 2017-05-05
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Pablo, Lillian
Sean Quinlivan
B: 1968-07-19
D: 2017-05-05
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Quinlivan, Sean
Gerald Hamel
B: 1996-06-12
D: 2017-04-29
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Hamel, Gerald
Myrna Johnson
B: 1943-11-28
D: 2017-04-27
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Johnson, Myrna
Sandra Norris
B: 1946-08-07
D: 2017-04-23
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Norris, Sandra
C.B. McNeil
B: 1937-02-17
D: 2017-04-20
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McNeil, C.B.
Betty Shima
B: 1925-03-03
D: 2017-04-18
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Shima, Betty
June French
B: 1930-02-11
D: 2017-04-17
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French, June
Anton Pichler
B: 1926-10-02
D: 2017-04-15
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Pichler, Anton
Lee Michel
B: 1960-03-14
D: 2017-04-12
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Michel, Lee
Thomas Martin
B: 1948-07-27
D: 2017-04-10
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Martin, Thomas
Gerald Zero
B: 1943-04-27
D: 2017-04-04
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Zero, Gerald
Kathy Skates
B: 1952-04-02
D: 2017-03-29
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Skates, Kathy
Virgil Cramer
B: 1924-02-05
D: 2017-03-29
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Cramer, Virgil
Ronald Knapp
B: 1959-09-06
D: 2017-03-21
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Knapp, Ronald

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Polson, MT 59860
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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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