Pre-registration for the Garden of Honor

First Name*

Middle Name

Last Name*

Suffix

Date of Birth*

Social Security Number*

Gender*

Male
Female

Email*

Address*

Street Address Address Line 2 City State ZIP Code

County*

Home Phone*

Cell Phone

Marital Status

Veteran's Military Service

Branch of Service*

Period of Service*

Ops Iraqi Freedom/Enduring Freedom
Peace Time
Persian Gulf
Vietnam
Korea
World War II

Date of Entry Into Service*

Date of Separation*

Rank/Pay Grade at Time of Discharge*

Do you anticipate that either your spouse or dependent children will also be interred at the cemetery?*

Yes
No

Upload a copy of your DD-214 or NGB Form 22

Optional Spouse Information

You should only complete this section if you are also pre-registering a spouse. If your spouse is also a Veteran or is currently serving on the military, this form can not be used. Instead, a separate application is required.

Spouse First Name

Spouse Middle Name

Spouse Last Name

Spouse Suffix

Is address the same as Veteran above*

Yes
No

If no, please fill in spouse address

Spouse Address

Street Address Address Line 2 City State ZIP Code

Spouse County

Spouse Home Phone

Spouse Cell Phone

Spouse Social Security

Spouse Date of Birth

Spouse Gender

Male
Female

Upload a copy of your marriage license

Online certification statement*

By checking this box, I certify that all information provided on this application and the supporting documents are true and correct to the best of my knowledge

Veteran's Military Service

Optional Spouse Information

Funerals

Cemetery

Monuments

Higgins Funeral Home