Patriot Guard Riders Pennsylvania
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Funeral Request Form – East



This form is STRICTLY for Funeral/Honor Mission Requests.  All other questions or concerns should be directed to:

or through direct contact with your Senior Ride Captain, Assistant State Captain or State Captain.


Please fill out this form with as much detail as you can provide.


Our Eastern PA Veteran Liaison will contact you as soon as possible.


Requests for Patriot Guard Riders attendance at funeral services for any active duty military/honorably discharged veteran and LEO/First Responders must come from an immediate family member, Funeral Director or Military Casualty Assistance Officer (CAO). Please fill out the form only if you are an authorized spokesperson for the family.  If you are not an immediate family member, one of them MUST contact us.



***Please allow sufficient notice of a minimum of 48 hours in order to plan and mobilize our people.***


If NO, the Honoree's Next of Kin or Funeral Director MUST contact our Veteran Liaison: and give specific authorization for PGRPA to attend.

PLEASE NOTE:  Motorcycle Escorts can not be guaranteed. We will never ask our members to ride outside their comfort zone, and/or safety levels.