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2. HOKE COUNTY FUNERAL ESCORT FORM

   This form is for requesting funeral escorts from the Hoke County Sheriff's Office and/or the Raeford Police Department

4. Funeral Home Name*
6. Funeral Home Contact Name*
7. Funeral Home Contact Telephone Number *
9. Name of Deceased*
11. Date and Time of Funeral*
    Date and Time of Funeral

    Date and Time of Funeral
12. Date and Time of Beginning of Escort*
    Date and Time of Beginning of Escort

    Date and Time of Beginning of Escort
14. Beginning of Escort-Location Name and Address*
16. Destination of Escort-Name and Address*
18. Is There a Secondary Destination?*

    1. Yes
    2. No
20. Date and Time of Secondary Destination Pick-up
    Date and Time of Secondary Destination Pick-up

    Date and Time of Secondary Destination Pick-up
22. Destination of Secondary Location-Name and Address
24. Was The Deceased a Law Enforcement Officer?*

    1. Yes
    2. No
25. Was the Deceased a Military Veteran?*

    1. Yes
    2. No
27. Was the Deceased Ever an Elected Official?*

    1. Yes
    2. No
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field