Obituaries

Robert Gruber
B: 1926-06-24
D: 2017-11-21
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Gruber, Robert
Donald Linn
B: 1960-03-06
D: 2017-11-12
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Linn, Donald
Jimmy Thurman
D: 2017-11-08
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Thurman, Jimmy
Mary Lou Hanks
B: 1933-01-12
D: 2017-11-08
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Hanks, Mary Lou
Gertrude Vilhauer
B: 1930-04-11
D: 2017-11-05
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Vilhauer, Gertrude
Harvey Kemper
B: 1921-10-31
D: 2017-11-02
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Kemper, Harvey
Charles Corbitt
D: 2017-11-02
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Corbitt, Charles
Mark McCoy
B: 1938-06-24
D: 2017-10-30
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McCoy, Mark
Glenda Tilley
B: 1955-12-30
D: 2017-10-30
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Tilley, Glenda
George Lovell
B: 1941-11-26
D: 2017-10-28
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Lovell, George
Joanne Perron
D: 2017-10-25
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Perron, Joanne
Charles Campbell
B: 1950-11-11
D: 2017-10-24
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Campbell, Charles
Mary Walls
B: 1942-12-01
D: 2017-10-24
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Walls, Mary
Walter Johnson
B: 1970-09-22
D: 2017-10-21
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Johnson , Walter
Ada Thompson
B: 1928-12-25
D: 2017-10-17
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Thompson, Ada
Bobby Williams
B: 1951-02-18
D: 2017-10-13
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Williams, Bobby
Mary Collister
B: 1932-05-17
D: 2017-10-12
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Collister, Mary
Velma Walker
D: 2017-10-03
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Walker, Velma
Doloris Frosaker
B: 1933-02-19
D: 2017-09-30
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Frosaker, Doloris
Larry Ellis
D: 2017-09-30
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Ellis, Larry
Leroy Davis
B: 1954-10-23
D: 2017-09-25
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Davis, Leroy

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218 Hwy 65 B
P.O. Box 1399
CLINTON, AR 72031
Phone: 501-745-6791
Fax: 501-745-6792

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I. Biographical Information
Full Name:
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 You In Death            
Your 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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