Funeral Ceremony Request

This form is to be used to request military funeral honors and must be filled out completely.

ONLY FUNERAL DIRECTORS IN LAST SALUTE’S AREA OF OPERATION ARE TO USE THIS FORM. REQUESTS FROM OUTSIDE THE SPECIFIED AREA OF OPERATION OR FROM PERSONS WITHOUT LEGAL AUTHORITY WILL BE DISREGARDED.

IMMEDIATELY AFTER COMPLETING FORM A VALID DD214 PROOF OF SERVICE MUST BE SENT TO [email protected] FAILURE TO SEND THE FORM WILL PREVENT YOUR CEREMONY REQUEST FROM BEING SCHEDULED.

    ------------------ For Funeral Director Use only ----------------------

    Telephone

    Cell Phone number of funeral director conducting funeral service

    Branch of Service MarineArmyNavyAir Force

    Rank

    Date of Ceremony

    Time of Ceremony

    Cemetery / location of honors

    All ceremonies include the playing of Taps followed by the folding and presentation of a memorial flag to be supplied by funeral director. Last Salute honors ceremonies also always include the memorial prayer box commitment ceremony.

    Additional honor ceremony components are listed below. Typically, all are approved when available.

    Civil War Cannon (single volley) YesNo
    (2 Cannons may requested if the deceased was awarded a Medal of Honor, Silver Star or multiple Purple Hearts. Include this information in the comments section.)
    Memorial bell tolled 3 times
    Rifle Salute 3 volleys YesNo
    (Subject to personnel availability.)

    Military Caisson Service / Dignified Military Transfer YesNo
    (Special purpose up armored military Humvee and artillery trailer)
    Location of pick-up

    Basic next of kin information is now required.

    Name
    Relation
    Address

    Before submitting, have you checked to make sure ALL fields are filled out? Incomplete forms may result in scheduling delays.

    Finally, only 1 honor guard per funeral service. If you are requesting Last Salute, do not also send a request to the military. Doing so stretches limited resources and is completely redundant.

    If you do not get a "Message Sent" message, please hit submit again.