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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:

Bishop Dr. France Holland
Born: 5/7/1930
Died: 12/14/2016
Stephen Metaxas
Born: 7/1/1991
Died: 12/6/2016
Maria Pietrek
Born: 11/28/1931
Died: 12/3/2016
Kevin Faethe
Born: 9/25/1977
Died: 12/2/2016
Judy Baker
Born: 12/27/1930
Died: 12/1/2016
Celia Gasca
Born: 9/17/1959
Died: 11/30/2016
Ralph Manfredi
Born: 8/2/1946
Died: 11/29/2016
Rosalba Verduzco-Almaguer
Born: 3/6/1962
Died: 11/25/2016
Rhoda Wilson
Born: 2/22/1943
Died: 11/23/2016

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