Funeral Escort Request Form

Print
Press Enter to show all options, press Tab go to next option

The Leesburg Police Department will escort funeral processions that start in, end in, or pass through the Town of Leesburg. This service is provided free of charge. We do request two days' notice, if possible.

To request a funeral escort, please complete the form below. A staff member of the Leesburg Police Department will contact you promptly to confirm the details of your request.

Please correct the field(s) marked in red below:

Requestor's Contact Information

 *
Requestor's Contact Information

Decedent's name

 *

Date of Funeral

 *

Start Time of Procession

 *

Estimated number of vehicles in procession

 *
Funeral Home Information
 *
Funeral Home Information

Service Information

 *
Service Information

Burial Information

 *
Burial Information

Please include any additional information regarding this funeral escort request?

  1. To receive a copy of your submission, please fill out your email address below and submit.
    CAPTCHA
    Change the CAPTCHA codeSpeak the CAPTCHA code