Funeral Home Request

North Texas Patriot Guard Riders

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Funeral Home Request
Home / About / Request presence / Funeral Services

Funeral Home - Funeral/Memorial Request

** IMPORTANT PLEASE READ **

THIS FORM IS FOR FUNERAL HOME USE ONLY

Before you request us please ensure you have the following:

Family authorization. We must be invited by the family.
Family contact information including name and phone number.
Funeral director contact information including name and phone number.
Will the military (if applicable) be present

Once submitted, your request will be sent immediately to the leadership team. We strive to answer all requests within a few hours, but no later than 24 hours from submission.

If you do not hear back from us within 24 hours please contact us at help@northtxpgr.org.

Please note - All fields marked with a * are required.

Deceased Information

Name of Deceased *

Status *

Branch of Military Service/First Responder *

Service Information - (years in service, WWII veteran, Vietnam era, etc.)

Deceased Photo Upload

Do you have a copy of the DD214? *

Yes

DD214 Upload

Funeral Director Information

Name *

Contact Number *

Email Address *

Date you are requesting our presence *

Time Requested *

Funeral Home Information

Funeral Home Name *

Funeral Home Address *

Phone Number *

Family Information

If you are not an immediate family member, please enter the name of the person we should contact.

Family Member Name *

Family Member Contact Number *

Family Member Email Address

Realtionship to Deceased *

Service Information

Location Name *

Location Contact

Contact Phone Number

Location Address *

Details *

Will the military be present? *

Yes

N/A

Do you need pallbearers? *

Yes

Does the PGR need to fold the flag? *

Yes

N/A

Cemetery Name

Cemetery Contact