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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:

Betty Cardenas
Born: 12/10/1944
Died: 2/8/2017
Jazmin Honorato Espana
Born: 6/4/2005
Died: 2/8/2017
Peter Klas
Born: 8/17/1936
Died: 2/8/2017
Mario Santos Jr.
Born: 10/26/1964
Died: 2/7/2017
Dorothy Appleton
Born: 2/10/1928
Died: 2/6/2017
Ronally Hernandez
Born: 1/1/1900
Died: 2/2/2017
Francisco Hernandez
Born: 10/9/1939
Died: 1/30/2017
Donavon Johnson
Born: 5/26/1997
Died: 1/29/2017
Glendon Mallette
Born: 4/13/1926
Died: 1/28/2017

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