Contact Information:
(Please complete the participation form by
providing the following information. Asterisk (*)
indicates required information fields to be completed.)
Department Name:
*
Department Telephone #:
*
Street Address:
*
City:
*
State:
* Zip Code:
*
Honor Guard Commander's
Information:
Commander's Name:
*
Rank:
*
E-Mail:
*
Cell Ph.#:
*
Office Ph.#:
Asst. Commander's Name:
Rank:
E-Mail:
Cell Ph.#:
Office Ph.#:
Participation
Information: (In order for the
Virginia Fire Service Honor Guard Command Staff to efficiently
allocate the provisions necessary for the scheduled memorial
service, the following information is required. Please
complete the following fields, by providing the appropriate
information. Thank You!)
Honor Guard Participation:
YesNo
*
Participating Members:
*
(Please enter the
number of participating Honor Guard members)
Flags:
Please indicate which flags your department will display.
City/County Flag:
F.D. Flag:
(Please do not bring
U.S. or Virginia state flags)
(Representing
fire department Honor Guard's displaying their flags
will be mandated to provide their own flag stands!)
Irons:
Please indicate if your department will be bringing
irons. Axes:
Pike Poles:
(Please
note that irons will be used based upon the discretion of
the command staff.)
Musicians
(Informational Purposes Only):
Please indicate if your department has the following
internal resources available within your Honor Guard.
Bagpipers:
Buglers:
(Must be proficient and
comfortable playing "TAPS")
Participation
Assignments: (Please indicate which
assignment your department personnel (Honor Guard) would be
interested in participating. These assignments are
strictly voluntary, but very important to the service and
families being honored. All other participation will be
unified in the processional of Honor Guard members. Please
keep in mind that these assignments are voluntary and the
command staff will make final decisions at the time of the
service. Your participation is very much appreciated by the families and VFFFMS Committee members.
Family
Escorts:
Yes
No
(Escorts will be
assigned to family members and will assist family members
with any amenities associated with honoring their loss.)
Family Escorts (Name):
(Please provide the name(s) of the individuals
wishing to participate as family escorts.)
Flag
Bearers:
U.S. Flag
Virginia State Flag
(Please indicate
which flag your department personnel (Honor Guard) would be
interested in carrying in the procession.)
City/County/F.D.
Flag
Flag Guards:
Yes
No
(A total of eight (8) flag
guards are needed for the processional.)
Flag
Guards (Name):
(Please provide the name(s) of the individuals
wishing to participate as flag guards.)
Tolling of
the Bell 5-5-5:
Reader;
Reading The
Tolling of the Bell History
Bell Toller;
Actual
Tolling of the Bell
(The
Reader will be responsible for the actual reading of the
history as it relates to the Tolling of the Bell, while the
Toller will be responsible for the actual tolling of the
bell.)
Reader's
Name:
Bell Toller's Name: