FWMES Funeral Escort Request Form

Fort Worth Motor Escort Service LLC

Funeral Escort Request Form
Your Name*
E-mail*
example@example.com
Director's Email (If Different)
example@example.com
Funeral Home*

Funeral Home Collapse
Please Type Funeral Home Name

Funeral Home Collapse Stopper
Number of Escorts*
Day/Date of Service*
Will there be a Family Escort required prior to the service?*

YesNo

Family Pickup Collapse
Pickup Address for Family Escort
Pickup Time for Family Escort

:HourMinutesAM/PM Option

Family Pickup Collapse Stopper
Service Location*
Time of Service*

:HourMinutesAM/PM Option
What time should escort riders arrive? *

:HourMinutesAM/PM Option
Burial Cemetery or DFW Gate Time*
Last Name of Deceased*
Will the Patriot Guard be involved in the procession?*

YesNo
PO Number
Additional Instructions
Should be Empty: