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Escude Funeral Home

To be placed in the permanent files of Escude Funeral Home.
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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:

Beverly Gauthier
Born: 1/26/1928
Died: 5/20/2017
Noemi Armand
Born: 3/7/1915
Died: 5/18/2017
Huron Rabalais
Born: 10/1/1922
Died: 5/16/2017
Birdie Guidry
Born: 9/16/1936
Died: 5/15/2017
Leslie Gauthier
Born: 12/30/1952
Died: 5/14/2017
Elizabeth Johnson
Born: 11/28/1937
Died: 5/11/2017
Luella Batiste
Born: 4/4/1937
Died: 5/8/2017
Joseph Meche, Sr.
Born: 9/25/1941
Died: 5/6/2017
Doris Wilson
Born: 7/7/1937
Died: 5/3/2017

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