Obituaries

Warren Rogers
B: 1944-10-18
D: 2018-02-13
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Rogers, Warren
Elliot Siedlecki
B: 1944-03-04
D: 2018-02-04
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Siedlecki, Elliot
Beverly Cote
B: 1924-03-28
D: 2018-02-04
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Cote, Beverly
Camella Levicki
B: 1924-10-15
D: 2018-02-03
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Levicki, Camella
Peter Fox
B: 1963-07-18
D: 2018-02-01
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Fox, Peter
Joseph Sena
B: 1959-02-02
D: 2018-01-29
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Sena, Joseph
Norman "Red" Cote
B: 1935-01-26
D: 2018-01-19
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Cote, Norman "Red"
Susan Orczyk
D: 2018-01-18
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Orczyk, Susan
Christian Onorato
B: 1986-07-13
D: 2018-01-15
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Onorato, Christian
Donna Plante
B: 1946-02-20
D: 2018-01-12
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Plante, Donna
Roger Goyette
B: 1939-09-25
D: 2018-01-09
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Goyette, Roger
Robert Brawn
B: 1966-05-05
D: 2018-01-05
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Brawn, Robert
Avery Shepard
B: 1931-04-23
D: 2018-01-03
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Shepard, Avery
Sophia Perron
B: 1921-09-18
D: 2018-01-02
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Perron, Sophia
Irene Mombourquette
B: 1915-06-11
D: 2018-01-01
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Mombourquette, Irene
Josephine Bouthillette
B: 1932-11-01
D: 2017-12-25
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Bouthillette, Josephine
Mark St. Andre
B: 1956-12-20
D: 2017-12-25
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St. Andre, Mark
Marjorie Brooks
B: 1926-08-31
D: 2017-12-23
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Brooks, Marjorie
Helen Donahue
B: 1928-07-05
D: 2017-12-23
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Donahue, Helen
Genevieve Mahassel
B: 1934-07-16
D: 2017-12-21
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Mahassel, Genevieve
Karen Miner
B: 1936-01-22
D: 2017-12-19
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Miner, Karen

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PO Box 75
North Grafton, MA 01536
Phone: (508) 839-4491
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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:
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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

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Visitation Hours:
Casket:
Person in Charge of Arrangements:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
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Outer Container Preference: (for ground burial)
Cemetery Name:
Cemetery Location:
The cemetery property is in the name of:

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