Request our services
(PLEASE READ THESE INSTRUCTIONS THOROUGHLY!)
The Patriot Guard ONLY attends missions and events by request.
Please use this form to request our services.
Once completed, PLEASE review to make certain all fields contain accurate information.
The more information you provide the sooner we can verify and expedite the request.
Note the fields that are mandatory are annotated with a red asterisk.
A representative will contact you as soon as possible.
*NOTE: To PRINT a copy of this completed form follow these steps:
1) PRIOR to clicking on the SUBMIT button.
2) RIGHT click anywhere on the form
3) SCROLL down to "print".
4) POINT and click on print your completed form.*
*Thank you for your request. Once you click submit, you will be redirected back to our Home page.*
Please check your email for submission confirmation.
Please Select Type of Mission Requested
Full Name of person mission is requested for
Date of Death
Name and Branch of Service (or first responder status) for who this request is being made
Date of Service requested
Hometown of person to be honored
Family Contact Person and Contact Information [Telephone number, postal mailing address, email address(if available)]
Name of Funeral Home
Funeral Home Contact Person and Telephone Number
Funeral Home Complete Address
Additional Mission Request locations. Church, Cemetery, Residence, Town Green etc.
Additional information and comments