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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:

Wenceslada Galvan
Born: 10/22/1927
Died: 1/18/2017
Arnold Fowkes
Born: 9/4/1941
Died: 1/17/2017
Alicia Penuiliar
Born: 8/2/1957
Died: 1/17/2017
Jose Sanchez-Arriaga
Born: 12/18/1942
Died: 1/14/2017
Richard Nelson
Born: 2/11/1998
Died: 1/14/2017
Rolando Curras
Born: 2/2/1928
Died: 1/9/2017
David Bradshaw
Born: 4/23/1956
Died: 1/9/2017
Frances MacDonald
Born: 5/5/1924
Died: 1/8/2017
Ernest Morano
Born: 10/28/1933
Died: 1/6/2017

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