Memorial Service Request (NOT FUNERAL DIRECTORS)
+ FOR FAMILY MEMBERS or FRIENDS ONLY.

+ FUNERAL DIRECTORS Please use the Funeral Directors request form under Funeral Directors information tab on the IMMHG home page.

+ This form uses SSL encryption for the security of the Veterans' information.

++If not redirected to the IMMHG home page after the form submission? Please check the boxes with a RED asterisk (*).

+A successful submission will redirect to the IMMHG home page.

+Once a form is submitted, an email will be sent to the requesting individual's email.
  • Last 4 of members' SSN (####)
  • Contact Information of the Onsite Director on the day of the service as accurate as possible.
  • Requestor's Email Address
  • - -
    Requestors Telephone Number
  • - -
    Please provide number of the actual onsite service representative.
  • Use the dropdown menu OR use the Special Request/Instructions to identify the exact address of your desired location. Please use commas at the end of each line rather than paragraph returns.
  • If not at a Cemetery. please provide the complete address where the ceremony will be held; using commas as the line separator rather than paragraph returns.
  • Full Team includes ALL options. Please Select ONE choice. Each ceremony includes a Flag folding either by Active Military or IMMHG.
  • / / :
    Enter the date and time of the services at the above location.
  • :
    Enter here the approximate time that the Military Honors portion of the service is to take place. IMMHG normally arrives 30 minutes prior.
  • Have you requested service members branch be present at this service?
  • Enter the mission number assigned by the military if or when you speak with them.
  • Rank is helpful for IMMHG to provide the appropriate level of service, especially in retirees.
  • Check all that apply.
  • How are the remains presented at the service?
  • Will there be a US Flag present for the service?
  • County where the military portion of the service is to take place.
  • Copy and paste the web address for the obituary
  • Copy and paste the obituary into this area.
  • Please enter here any information that would be helpful for the IMMHG team and the Military to know in fulfilling your request for services. Please use commas as the line spacer rather than paragraph returns.
  • Choose the name of the file that is the scanned image of the deceased's DD 214 or Certificate of Honorable Discharge or VA card. Must be a .gif, .jpg, .jpeg, or .pdf file type.

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