Obituaries

Deanna Roettger
B: 1940-02-16
D: 2017-11-17
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Roettger, Deanna
Naaman Shively
B: 1936-10-16
D: 2017-11-11
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Shively, Naaman
Kenneth Davis
B: 1944-09-23
D: 2017-11-02
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Davis, Kenneth
Robert Thacker
B: 1937-04-08
D: 2017-10-30
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Thacker, Robert
James Bowles
B: 1946-01-28
D: 2017-10-27
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Bowles, James
Russell Bennett
B: 1927-11-11
D: 2017-10-23
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Bennett, Russell
Lea Ross
B: 1943-02-22
D: 2017-10-23
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Ross, Lea
Euradell Atkins
B: 1928-07-12
D: 2017-10-16
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Atkins, Euradell
Mary Roach
B: 1924-04-19
D: 2017-10-09
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Roach, Mary
David Eanes
B: 1955-08-03
D: 2017-10-06
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Eanes, David
Ezra Barnes
B: 1946-05-06
D: 2017-10-02
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Barnes, Ezra
Daniel O'Dell
B: 1944-09-05
D: 2017-10-01
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O'Dell, Daniel
Trula Fields
B: 1924-10-12
D: 2017-09-29
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Fields, Trula
Franklin Frazier
B: 1940-08-20
D: 2017-09-18
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Frazier, Franklin
Herman Powell
B: 1929-09-06
D: 2017-09-15
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Powell, Herman
Robert Thomas
B: 1974-04-07
D: 2017-09-05
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Thomas, Robert
Carl Spencer
B: 1937-11-30
D: 2017-08-29
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Spencer, Carl
Janet Bennett
B: 1934-04-01
D: 2017-08-20
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Bennett, Janet
Gilmer Morris
B: 1925-09-11
D: 2017-08-12
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Morris, Gilmer
Hilda Ayers
B: 1950-04-19
D: 2017-08-09
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Ayers, Hilda
James Viars
B: 1951-03-06
D: 2017-07-22
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Viars, James

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103 Clearview Drive
Martinsville, VA 24112
Phone: (276) 632-1880
Fax: (276) 638-5373

Immediate Need

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

To report a death to Roselawn Chapel Funeral Home, please notify us first by phone at (276) 632-1880.

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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