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Davis Funeral Homes & Memorial Park
EASY FUNERAL PRE-PLANNING FORM
 

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

Person Completing this Form*:
Relationship*:
Email*:
 
Pre-arrangement Guide For
Full Legal Name*:
(no initials please)
Address:
(no P.O. Box)
City:
State:
Zip:
Date of Birth:
(mm/dd/yyyy)
Place of Birth:
Father's Full Name:
Mother's Full Maiden Name:
Highest Level of Education Completed:
Degree:
Veteran: Yes No
Military Branch:
Dates of Service:
Occupation:
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:
Cemetery:
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:

 
Kathlyn Hayes
Born: 10/29/1958
Died: 4/16/2017
Madaline Menkens
Born: 9/9/1997
Died: 4/14/2017
Maria Cepeda
Born: 1/2/1948
Died: 4/13/2017
Susan Wagner
Born: 2/25/1957
Died: 4/12/2017
Courtney Fuhriman
Born: 6/1/1929
Died: 4/11/2017
Kathleen Jones
Born: 2/15/1949
Died: 4/10/2017
Lourdes Castaneda
Born: 5/10/1952
Died: 4/6/2017
Joanne Evans
Born: 7/28/1933
Died: 4/4/2017
Russkien Barcenilla
Born: 7/4/1992
Died: 4/2/2017

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