Obituaries

Henry Kozubal
B: 1924-05-16
D: 2018-12-04
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Kozubal, Henry
Fredrick Fulton
B: 1949-06-26
D: 2018-12-03
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Fulton, Fredrick
Ernest Winters,
B: 1954-11-06
D: 2018-11-25
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Winters,, Ernest
Ladine Osinski
B: 1968-11-28
D: 2018-11-19
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Osinski, Ladine
John Krueger
B: 1937-10-22
D: 2018-11-18
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Krueger, John
Malinda Peterson
B: 1961-12-07
D: 2018-11-17
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Peterson, Malinda
John Klebba
B: 1956-08-23
D: 2018-11-16
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Klebba, John
Lawrence Whiting
B: 1949-12-05
D: 2018-11-12
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Whiting, Lawrence
Alyce Olsen
B: 1928-10-22
D: 2018-11-10
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Olsen, Alyce
Deacon Gene Brah
B: 1953-01-20
D: 2018-11-03
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Brah, Deacon Gene
Lois Zingle
B: 1918-03-18
D: 2018-11-03
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Zingle, Lois
Eliga Roach
B: 1927-01-01
D: 2018-11-03
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Roach, Eliga
Diane Stanik-Martin
B: 1930-12-25
D: 2018-11-02
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Stanik-Martin, Diane
Harold Dickman
B: 1936-04-04
D: 2018-10-21
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Dickman, Harold
Glenn Stach
B: 1923-04-15
D: 2018-10-14
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Stach, Glenn
Phillip Wilke
B: 1943-12-16
D: 2018-10-14
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Wilke, Phillip
Edwin Lasco
B: 1929-08-19
D: 2018-10-14
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Lasco, Edwin
Claire Nendza
B: 1947-06-14
D: 2018-10-10
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Nendza, Claire
John Huntress
B: 1957-05-03
D: 2018-10-06
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Huntress, John
Brian Gates
B: 1945-01-07
D: 2018-10-06
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Gates, Brian
Edward Leahy
B: 1933-07-27
D: 2018-10-05
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Leahy, Edward

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Lake Geneva, WI 53147
Phone: 262-248-2320
Fax: 262-248-4422

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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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