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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:

 
Helen Kissel
Born: 8/5/1920
Died: 2/8/2016
Jamie Blanco-Vega
Born: 9/27/1930
Died: 2/8/2016
David Drew
Born: 9/22/1955
Died: 2/5/2016
Elizabeth Thomas
Born: 12/28/1938
Died: 2/5/2016
Ernest Fisher Jr.
Born: 2/11/1956
Died: 2/4/2016
Charles Semones
Born: 6/10/1932
Died: 2/3/2016
James Gagliano
Born: 6/19/1930
Died: 2/2/2016
Patrick Snyder
Born: 3/18/1932
Died: 2/1/2016
Sally Keener
Born: 3/26/1943
Died: 1/29/2016

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