Funeral Escort Request

Funeral Escort Request form " Burial Service"

Funeral Home: *

Date of Service: *

Time of Service: *

Escort Spot Time: *

Name of Service: *

Email Address: *

Contact Number: *

# of Escorts Requesting - Min of two

Procession Description: *

Procession Start Address/Details *

Cemetery

Destination:

Military Service: *

Fort Logan Service Time:

Fort Logan Staging Area

Additional Escort Service Details

Funeral BLK Limousine Request - 9 Passenger*

Funeral Limousine Service Details

Please include : Pick-up, Drop-off, Arrival and Departure times, Location Addresses, Rider Contact #, and as much detail as possible.

Request form completed by: *

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Contact Information

City-Wide Protection, Inc.

Phone: 303-557-8454

PLEASE NOTE

Staff may be in the field and will return messages as soon as possible

Hours of operation:

Mon-Fri: 8-5pm

Sat: on-call

Sun: on-call

Serving the Denver Metro Area