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2. 
3. Kinston Department of Fire and Rescue
   P. O. Drawer 339, 401 E Vernon Avenue Kinston, North Carolina 28502 Office Phone: 252-939-3164 Fax Phone : 252-939-3157
5. Kinston Fire & Rescue Honor Guard Request Form
7. Requester Information
8. Date of Request*
   Date of Request
10. Name of Requester:*
11. Middle Name:
12. Last Name:*
14. Address:*
16. City:*
17. State:*
18. Zip Code:*
20. Contact Phone Number:*
21. Email Address:*
23. Information of Event Planned
25. Honor Guard Community Flag Detail Ceremony
    
26. Flag Folding and Presentation Ceremony
    
27. Pallbearer Service
    
29. Requested Honor Guard Services at the Event:

    1. Community Flag Detail Ceremony
    2. Flag Folding and Presentation Ceremony
    3. Pallbearer Service

    1. Casket Guard Service
    2. Bagpipe Service (for Firefighter In-Line Duty Deaths Only)
31. Casket Guard Service
    
32. Bagpipe Service
    
34. Date of Event:*
    -- Select One --JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember
35. Day:*
    -- Select One --01020304050607080910111213141516171819202122232425262728293031
36. Year:*
    -- Select One --201720182019202020212022202320242025202620272028202920302031203220332034203520362037
38. Starting Time of Event:*
    -- Select One --6:00 AM7:00 AM8:00 AM9:00 AM10:00 AM11:00 AM12:00 PM1:00 PM2:00 PM3:00 PM4:00 PM5:00 PM6:00 PM7:00 PMOther
39. If Other is selected please list Time Requested:
41. Note: The Kinston Fire & Rescue Honor Guard arrives an hour prior to an event to evaluate the layout of the area, receive any last minute instructions and to rehearse the ceremony requested.
43. Address of the Event:*
45. City:*
46. State:*
47. Zip Code:*
49. Contact Person Information (If not Requester)
51. Contact Name (If not same as Requester):
52. Last Name:
54. Contact Phone Number (If not same as Requester):
Leave This Blank:


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit Submit and Print

* indicates a required field