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Submit an Obituary

Many families ask us “May we write the obituary for the newspaper?” The answer of course is “yes” for our local newspaper called The Patriot. This form is a guide for you to help you with the information that is needed. Please feel free to fill it out, then print it, and bring this form with you for the arrangement conference with one of our directors.

Name of Deceased:				Age:
Residence:				Date Passed Away:
Place of Death:				Employment:
Military Status::
Memberships:

Survivors:	Husband Wife Partner		Survivor Name:
# of Children:		Names of Children:
# of Brothers:		Names:
# of Sisters:		Names:
# of Grandchildren:		No. of Great Grandchildren:			No. of Great-Great Grandchildren:
Other Survivors you would like mentioned:

Services will be celebrated on:				Services Held At:
Viewing or Visitation Time and Place:				Cemetery Information:
Memorial Contribution Instructions:
Other Information you would like printed:
Would you like this obituary posted on our web site?		Yes No
Your Name:
Your E-mail:

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GILBERT L. DAILEY FUNERAL HOME, INC.

Submit an Obituary