Request Funeral, Memorial or Graveside Attendance

Use the form below to request the North Texas Patriot Guard Riders for a funeral. memorial or graveside service. Some information is optional, but is helpful if known and provided. Please only provide what you are comfortable with including.

Please note that we must be invited by the immediate family. If the requester is making the request on the behalf of the family; contact information for an immediate family member must be provided to confirm the family’s consent.

If you do not hear back from us within 48 hours please contact us at help@northtxpgr.org.

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

EFFECTIVE APRIL 10, 2023 – IN ORDER TO ALLOW AMPLE TIME TO PROCESS YOUR REQUEST FOR OUR PRESENCE, PLEASE ALLOW A MINIMUM OF 48 HOURS PRIOR TO YOUR DESIRED SCHEDULE DATE AND TIME. REQUEST FOR OUR PRESENCE ON A MONDAY MUST BE RECEIVED BY US NOT LATER THAN FRIDAY AT 12 NOON. REQUESTS AFTER THAT TIME CANNOT BE HONORED.

    Deceased Information

    Deceased Name *


    Status *

    Military Service or First Responder

    Service Information

    Deceased Photo Upload


    *The file size MUST be less than 2MB.

    Do you have a copy of the DD214?



    *The file size MUST be less than 2MB.

    Requestor

    Requester's Name *


    Your Relationship to Deceased *

    Contact Number

    Email Address *

    FAMILY INFORMATION

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

    Family Member Name


    Relationship to Deceased

    Family Member Contact Number

    Family Member Email Address

    SERVICE INFORMATION

    Date you are Requesting Our Presence*

    Service Start Time*

    :

    Casket / Urn*

    Service Details*

    FUNERAL HOME INFORMATION

    Funeral Home Name

    Name of Funeral Director


    Phone Number

    Funeral Home Address




    LOCATION INFORMATION

    Location Name

    Location Contact


    Contact Phone Number

    Location Address




    Details

    CEMETERY INFORMATION

    Cemetery Name

    Cemetery Contact


    Contact Phone Number

    Cemetery Address




    Details