Obituaries

Willis Purvis
B: 1939-01-10
D: 2017-08-21
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Purvis, Willis
John Wilson
B: 1946-09-16
D: 2017-08-16
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Wilson, John
Anthony Denicola
B: 1971-03-20
D: 2017-08-14
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Denicola, Anthony
Frances Johnson
B: 1950-05-28
D: 2017-08-13
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Johnson, Frances
Erwin Freeman
B: 1957-05-04
D: 2017-08-13
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Freeman, Erwin
Derek Stuart
B: 1984-06-02
D: 2017-08-10
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Stuart, Derek
Jason Wisecarver
B: 1961-11-15
D: 2017-08-09
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Wisecarver, Jason
William Pepper
B: 1952-06-06
D: 2017-08-07
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Pepper, William
Hullen Guilliams
B: 1932-04-08
D: 2017-08-07
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Guilliams, Hullen
Joshua Nguyen
B: 1955-04-06
D: 2017-08-06
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Nguyen, Joshua
Lucille Benson
B: 1924-12-17
D: 2017-08-06
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Benson, Lucille
Bernadette Maschke
B: 1946-04-18
D: 2017-08-05
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Maschke, Bernadette
Angela Milby
B: 1975-09-19
D: 2017-08-04
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Milby, Angela
William Clampit
D: 2017-08-02
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Clampit, William
Henry Russ, III
D: 2017-08-02
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Russ, III, Henry
Soloman Ledet
D: 2017-08-01
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Ledet, Soloman
Dean Prohaska
B: 1966-12-02
D: 2017-07-30
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Prohaska, Dean
Mark Barton
B: 1955-08-09
D: 2017-07-28
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Barton, Mark
Marie Lee
B: 1932-10-20
D: 2017-07-27
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Lee, Marie
Johnny Massey
B: 1944-03-11
D: 2017-07-24
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Massey, Johnny
John Lester
D: 2017-07-23
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Lester, John

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P.O. Box 1515
West Monroe, LA 71291
Phone: (318) 396-3191
Fax: (318) 396-3135

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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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