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Davis Funeral Homes & Memorial Park

To be placed in the permanent files of Davis Funeral Homes & Memorial Park.
*Require fields

Person Completing this Form*:
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
(no P.O. Box)
Date of Birth:
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Veteran: Yes No
Military Branch:
Dates of Service:
Spouse's Full Name:
(Wife's maiden name, if applicable)
Religious Affiliation/Congregation:
Family Member Information

Family Member #1

Funeral Arrangement Details
Person in charge of arrangements:
Place of service or gathering:
If Other, please specify:


Preference for final disposition:
If Other, please specify:
Disposition of cremated body:

In the space provided below, please share any information that would be helpful in creating a meaningful service. (ie. favorite hobbies, places, music selections, poems, scripture, etc.)

Any final thoughts that should be shared?


Do you wish to be contacted to discuss the details
of these arrangements, cost or payment options? Yes No

If yes, how should we contact you:
Phone Number:

If no, we will keep this information on file until you or your surviving family requests it.

  security code
Enter Security Code:

Tony Russo
Born: 11/23/1925
Died: 3/18/2017
Mercedes Bitong
Born: 2/25/1955
Died: 3/18/2017
Carole Willden - Bloominger
Born: 12/25/1927
Died: 3/16/2017
Sheila Scott
Born: 6/5/1929
Died: 3/16/2017
George Spath
Born: 1/29/1956
Died: 3/14/2017
Theo Cachero
Born: 11/2/1954
Died: 3/6/2017
Jasmine Llanos
Born: 9/3/1992
Died: 3/5/2017
Jacqueline Hernandez
Born: 10/17/1966
Died: 3/5/2017
Kenneth Steele
Born: 7/3/1937
Died: 3/5/2017

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Davis Funeral Homes & Memorial Park | 6200 South Eastern Avenue | Las Vegas, NV 89119 | 702-736-6200
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