Funeral Order Form

Please fill out the form below to reserve vehicles. Once your order is submitted you will receive a confirmation via email. For additional information please call our office at (203) 934.6331 or (800) 255.5466.

( denotes required fields)*

Funeral Home *
Date of Service *
Deceased Name *

Limousines:

Driver *
Pick-up time *
Pick-up location *
Number of limousines

Hearses:

Driver *
Pick-up time *
Pick-up location *
Number of hearses

Additional Information:

Additional Comments
Contact Phone #
Email *

Enter the code shown above

More Info

Funeral Order Form

(* denotes required fields)

Limousines:

Hearses:

Additional Information:

( denotes required fields)*