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Escude Funeral Home

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

Nathan Guillory
Born: 2/5/1946
Died: 8/18/2017
Cecilia Laborde
Born: 10/22/1934
Died: 8/14/2017
Barbara Davis
Born: 3/28/1966
Died: 8/12/2017
Dora Gaspard
Born: 7/31/1940
Died: 8/11/2017
Carrie Washington
Born: 4/20/1942
Died: 8/8/2017
Lucille Dauzat
Born: 4/1/1956
Died: 8/4/2017
Jeffrey McGlory
Born: 1/23/1988
Died: 8/4/2017
Cecilia Lemoine
Born: 10/29/1922
Died: 8/4/2017
Ernest Gremillion, III
Born: 5/11/1950
Died: 8/2/2017

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