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Davis Funeral Homes & Memorial Park

To be placed in the permanent files of Davis Funeral Homes & Memorial Park.
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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:

Bedros Sarkhanian
Born: 12/25/1937
Died: 9/30/2015
Cristina Ortal
Born: 7/9/1929
Died: 9/29/2015
Maria De Giron
Born: 2/10/1922
Died: 9/29/2015
Vicki Jackson
Born: 1/20/1950
Died: 9/28/2015
Mary Heinrichs
Born: 3/20/1937
Died: 9/25/2015
Ruben Cabanas
Born: 11/4/1924
Died: 9/24/2015
Romarico Juan
Born: 9/15/1938
Died: 9/24/2015
Desiree Guillen
Born: 6/12/1982
Died: 9/24/2015
Mike Martinez
Born: 9/29/1922
Died: 9/23/2015

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