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

To be placed in the permanent files of Davis Funeral Home & 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:
 

Names of Family Members (Where do they live)

Family Member #1 Name:
City:
State:
Relationship:
Family Member #2 Name:
City:
State:
Relationship:
Family Member #3 Name:
City:
State:
Relationship:
Family Member #4 Name:
City:
State:
Relationship:
Family Member #5 Name:
City:
State:
Relationship:
Family Member #6 Name:
City:
State:
Relationship:
Family Member #7 Name:
City:
State:
Relationship:
Family Member #8 Name:
City:
State:
Relationship:
 
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:

 
William Wiedeman
Born: 6/20/1929
Died: 12/14/2014
Judith Braga
Born: 10/26/1954
Died: 12/13/2014
Bonnie Duerinsk
Born: 1/21/1924
Died: 12/8/2014
Charles Velasquez
Born: 4/26/1961
Died: 12/6/2014
Joy Bishop
Born: 4/17/1965
Died: 12/6/2014
Marie Arnephy Pritchard
Born: 10/28/1924
Died: 12/6/2014

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