Obituaries

James Stubblefield
B: 1940-10-15
D: 2017-07-17
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Stubblefield , James
James Downing
B: 1950-03-01
D: 2017-07-14
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Downing, James
Charles Rosson
B: 1944-08-02
D: 2017-07-08
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Rosson, Charles
Arnold Delco
B: 1946-11-11
D: 2017-07-05
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Delco, Arnold
Clare Eaton
B: 1926-09-22
D: 2017-06-30
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Eaton, Clare
Genevieve Standiford
B: 1929-06-02
D: 2017-06-29
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Standiford , Genevieve
Clifford Reller
B: 1952-06-14
D: 2017-06-28
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Reller, Clifford
Robert Brockmann
B: 1945-01-08
D: 2017-06-28
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Brockmann, Robert
Mary Bogner
B: 1919-06-08
D: 2017-06-23
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Bogner, Mary
Richard Pope
B: 1967-10-04
D: 2017-06-23
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Pope, Richard
Ralph Clark
B: 1934-10-19
D: 2017-06-20
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Clark, Ralph
Raymond Horton
B: 1920-09-04
D: 2017-06-14
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Horton, Raymond
Kenneth Price
B: 1935-07-06
D: 2017-06-13
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Price, Kenneth
Donald Hartford
B: 1928-04-27
D: 2017-06-12
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Hartford, Donald
Robert Jackson
B: 1939-04-11
D: 2017-06-03
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Jackson, Robert
Sandra Rehm
B: 1941-02-28
D: 2017-06-01
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Rehm, Sandra
Eva Wilkinson
B: 1916-02-09
D: 2017-05-28
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Wilkinson, Eva
Jagan Kaul
B: 1928-06-03
D: 2017-05-26
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Kaul, Jagan
Dorothy Cameron
B: 1925-02-11
D: 2017-05-21
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Cameron, Dorothy
Clark Hadfield
B: 1927-02-27
D: 2017-05-16
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Hadfield, Clark
Bruce Paprock
B: 1951-12-03
D: 2017-05-10
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Paprock, Bruce

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965 W. Harvard Blvd.
Roseburg, OR 97471
Phone: (541) 673-4455
Fax: (541) 673-1290

Immediate Need

First, let us say that we are so sorry for your loss.

To report a death to Wilson's Chapel of the Roses, please notify us first by phone at (541) 673-4455.

After that call, we will take your loved one into our care and will confirm a time/date for the arrangement conference. If you would prefer to expedite your time with our staff during that arrangement process, you may enter your loved one's basic information in this form below.


I. Informant Information

Full Name of Informant:
Relationship to Deceased:
Informant's Phone Number:
Informant's Email Address:

II. Decedent's Biographical Information

Full Name of Decedent:
Date of Death:
Decedent's Address:
City Name:
State:
Zip Code:
Telephone Number:
Date of Birth:
City of Birth:
State of Birth:
Highest Education Level:
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/Residence
Preceded Relatives
Occupation:
Industry:
Employer's Name:
Church Membership:
Club Affiliations:

III. Decedent's Military Record

Veteran:
Branch of Service:
Serial Number:
Date Enlisted:
Date of Discharge:
Rank at Discharge:
Time of Military Service:
Military Honors at Graveside:
Flag Preference for Service:

III. Service Preferences

Type of Service:
Visitation Hours:
Casket:
Officiating Clergy:
Pallbearers:
Flower Preference:
Music Selection:
Jewelry:
Glasses:
Casket Preference:
Disposition:
Cemetery Name:
Cemetery Location:

Miscellaneous Notes and Instructions:


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