Campbell-Lewis Funeral Home, Inc.
At Need Form
Personal Information
Name:
Address:
City:
State/Province:
Country::
Zip Code:
Place of Birth:
Date of Birth:
Sex:
Male
Female
Citizenship:
Marital Status:
Married
Widowed
Never Married
Divorced
Spouse (Maidenn Name):
Father's Name:
Mother's Maiden Name:
SSN:
Religous Preference:
Education
High School Name:
# of Years:
College Name:
Family Information: Please list the names of survivors and state their relationship to the deceased, their spouse's names and the city in which they live as you wish to have them listed in the memorial. (The following is a guide to assist you.) SURVIVORS: Spouse, Sons, Daughters, Parents, Brothers, Sisters, Grandchildren, (Great-grandchildren), Grandparents, Others (Eg. Son: Joe Smith and his wife Paula of Milledgeville)
Survivors:
Preceded in Death by::
Additional Information and Organ:
Work History
Occupation:
Business:
Industry:
Company:
Number of Years:
Years Retired:
Military Service
Service Branch:
Serial Number:
Date Enlisted:
Rank at Discharge:
Date Discharged:
Discharge on File At:
Combat Action:
Funeral Preferences
Funeral Service to be
Public:
Private:
Visitation
Public:
Private:
Place of Service:
Chapel
Cemetery
Church
Other
Other:
Service Type
Cremation:
Burial:
Entombment:
Contact Information
Name:
Address:
City:
State:
Zip Code:
Phone Number:
Email:
Relation:
For security, please enter the letter or number displayed in the corresponding box below each character. The letters do not have to be capitalized
Home Page
History
Staff
Services
Merchandise
Flower Shops
Cemeteries
Monument dealers
Resources
At Need Form
Pre-Planning Form
Frequently Asked Questions
Griefwords
Planning a Funeral
Obituaries
Recent Obituaries
Kenneth Blumhorst
Maxine Worley
Peggy Williams
Kenneth Van Arsdale
Marion Klausing
Charles Petty
SFC Trenton Rhea
Raymond Thomas
Jim Smith
Franklin Bakert
Terressa Hughart
Wilfred (Wayne) Brandt
Viola Embrey
Pauline Graham
Ryler Hunter
View all...