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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:

 
John Bailey
Born: 12/15/1922
Died: 9/20/2017
Albino Gonzales
Born: 4/8/1940
Died: 9/20/2017
Varada Reddy
Born: 8/25/1947
Died: 9/20/2017
Frans Zwarts
Born: 8/5/1926
Died: 9/20/2017
Gary Wood
Born: 7/18/1950
Died: 9/19/2017
Lance Hinds Biddulph
Born: 7/9/1991
Died: 9/18/2017
Lee Kjelland
Born: 3/12/1925
Died: 9/17/2017
Elvira Holden
Born: 1/16/1928
Died: 9/16/2017
Patrick Hogan
Born: 1/9/1985
Died: 9/16/2017

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