Seagle Funeral Home
SERVING SOUTHWEST VIRGINIA SINCE 1880




Subject 


First Name 


Middle Name 


Last Name 


Sex 


Date of Birth 


SSN 


Armed Services? 


Branch 


Serial Number 


Date enlisted 


Date of Discharge 


Rank at Discharge 


brief military history with any honors 


State of Residence 


County of Residence 


City of Residence 


Within City Limits? 


Address 


Phone Number 


Father's Name 


Mother's Name 


Race 


Education 


Citizen of what Country 


Birthplace 


Marital Status 


Serviving Spouce 


Daughters
(names and place of living) 


Sons
(names and place of living) 


Brothers
(names and place of living) 


Sisters
(names and place of living) 


Grandchildren 


Great-grandchildren 


Usual or Last Occupation 


Name and place of Cemetery 


Desired form of Disposition 


Suggested place for funeral and visitation 


Memorial Donations 


Church Affiliations 


Ministers 


Civic and Fraternal Affiliations 


Newspapers 


Special Music


How would you like to be contacted 
(please leave contact info)

 




 
© 2003 Seagle Funeral Home