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The Bastrop County Veteran's Honor Guard

MILITARY HONORS REQUEST FORM

Funeral Home Information

Funeral Home Name *

Funeral Home Rep. *

Contact Phone Number *

Rep's email *

About the Veteran

First Name *

Last Name *

Date of Death *

Date of Birth

Religion

About the Veteran's Military Service

Branch of Military Service *

Rank *

Are you in possession of the Veteran's DD-214 or Proof of Service *

Yes

No

Attachment: Attach DD-214 or Proof of Service here: *

You must attached a copy of the DD-214 or Proof of Service before sending this form. The Honor Guard cannot proceed without it.

Military Campaigns (check all that apply)

About the Funeral Service

Date of Funeral *

Time of Funeral *

Name of Cemetery *

Arrival Time at Cemetery *

Changes Call Number

Family Member/Friend Making Arrangements

First Name *

Last Name *

Relationship to Deceased *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number

Email Address

The following services WILL BE provided:

a. Flags (US Flag at minimum - more if possible)
b. Honor Guard Chaplain to Conduct the Service
c. Rifle Salute of Three (3) Volley's Fired
d. Flag Presentation to Family Member
e. TAPS

About the Casket Flag *

Flag Folding to Occur at the Cemetery

Flag Pre-Folded

Remarks/Special Requests