Obituaries
& Tributes

(330) 385-1010
Immediate Need

Pre-Arrange
Your Funeral

Contact
Us

Site
Search

Vital Information

You may file vital statistics and preferred funeral information with us on-line by filling in the form below.

 
Your Information
Your Name:                                   
Your Telephone Number:               (xxx-xxx-xxxx)
Your Email Address:            
 
I. Biographical Information
Full Name:
Address1:
Address2:
City Name:
State:
Zip Code:
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 Are Deceased (Immediate Family)
Occupation:
Type of Business:
Company Name:
Church Membership:
Lodge or Club Memberships:

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:

Miscellaneous Notes and Instructions:

 

 

 

 

 

 

 

 

 

 

 

 

 

Immediate Need

If you have immediate need of our services, we're available for you 24 hours a day.

Obituaries & Tributes

It is not always possible to pay respects in person, so we hope that this small token will help.

Pre-Arrangement

A gift to your family, sparing them hard decisions at an emotional time.

Order Flowers

Offer a gift of comfort and beauty to a family suffering from loss.

Daily Grief Support by Email

Grieving doesn't always end with the funeral: subscribe to our daily grief support email, designed to help you a little bit every day, by filling out the form below.

Proudly Serving the Communities of East Liverpool and the entire Tri-State Area

215 West Fifth Street | East Liverpool, OH 43920 | Fax: (330) 385-1163 | Email: fdikedawson@dawsonfuneralhome.com