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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:

Gary Sanderson
Born: 8/19/1944
Died: 7/31/2015
Gail Ferazzoli LeBoeuf
Born: 8/6/1958
Died: 7/26/2015
Richard Oliver
Born: 9/5/1937
Died: 7/25/2015
Elmer Ruiz
Born: 1/22/1959
Died: 7/24/2015
Frank Norte
Born: 3/9/1929
Died: 7/23/2015
Jose Campos
Born: 6/18/1998
Died: 7/23/2015
Marie Mundy
Born: 12/22/1925
Died: 7/19/2015
Philip Del Pedraza
Born: 9/6/1936
Died: 7/16/2015
Rhonda Brinkerhoff
Born: 1/16/1966
Died: 7/16/2015

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