HTML version of the form: National Military Cemetery of the Canadian Forces – Registration form for section 103

Eligibility

1. Eligibility for interment in the National Military Cemetery is restricted for serving or honourably released members of the Canadian Armed Forces (Regular or Reserves) and Canada’s Merchant Navy.
2. Each eligible applicant, as identified in Section A of this form, can designate one immediate family member, in Section B below, to be interred in the same burial plot as the applicant. If the immediate member is eligible as per para 1, and request to be interred in their own plot, a separate application form must be filled.
3. Immediate family member definition: spouse, common-law partner, father, mother, brother, sister, child or any other person deemed to be the Next of Kin of the applicant.
4. For more info: www.canada.ca/national-military-cemetery.
5. National Military Cemetery - Veterans Affairs Canada, Section 27: For more information please call the Last post fund at 1-800-465-7113.

Completion of this application form

6. If an applicant is unable to complete this form, it may be completed and signed on behalf of the applicant, by an individual who has the legal authority to do so. Should this be the case, a note to this effect should be affixed to the form and the name of the signing individual clearly printed and legible (in the comments section).

Verification of the military history

7. The eligibility of each applicant will be established in every case. The Canadian Armed Forces requires 10 working days to process applications but will endeavour to complete this process as quickly as possible.

Section A – Applicant

• Service / Regimental number:
• Rank:
• Last name:
• First name:
• Initial(s):
• Maiden name :
• DOB (yyyy-mm-dd):
• Address:
• City:
• Province:
• Postal code:
• Telephone number:
• Telephone (other):
• E-mail address:
• Service (check if applicable):
  • Regular
  • Reserve
  • Cadet instructor corps
  • Rangers
• Environment:
  • Navy
  • Land
  • Air
• Trades(s):
• Enrolment date (yyyy-mm-dd):
• Release date (yyyy-mm-dd):
• Release type:
• Decorations (post nominals):
• Date of death (yyyy-mm-dd) (if applicable):
• Preferred badge for headstone (as per your Occupation/Branch/Element):
• Preferred religious symbol for headstone (if applicable):
• Applicant comments:

Section B - Family member (fill what is applicable only)

• Service / Regimental number:
• Rank:
• Last name:
• First name:
• Initial(s):
• Maiden name:
• DOB (yyyy-mm-dd):
• Address:
• City:
• Province:
• Postal code:
• Telephone number:
• Telephone (other):
• E-mail address:
• Service (check if applicable):
  • Regular
  • Reserve
  • Cadet instructor corps
  • Rangers
• Environment:
  • Navy
  • Land
  • Air
• Trades(s):
• Enrolment date (yyyy-mm-dd):
• Release date (yyyy-mm-dd):
• Release type:
• Decorations (post nominals):
• Date of death (yyyy-mm-dd) (if applicable):
• Preferred badge for headstone (as per your Occupation/Branch/Element):
• Preferred religious symbol for headstone (if applicable):

Section C - Internment information

All applicants and family members who meet the eligibility criteria outlined in para 1, except in service deaths, are entitled to a military presence guard, padre, bugler and piper, if they so wish. However, the provision of this support depends upon availability and may not always be possible due to other military activities in the National Capital Region or short notice internment request. *Please note a notice of 5 working days is required to best provide this support.

Do you wish to have (check all applicable):

• None
• Military presence (Guard)
• Bugler (Last post)
• Piper (Lament)

Section D – Signature

By signing this document you give DSCM staff consent to access Military Service History to complete the registration process.

Signature:

Date (yyy-mm-dd):

For use of DCSM staff

Director Casualty Support Management
National Military Cemetery of the Canadian Forces
Major-General George R. Pearkes Building
101 Colonel By Drive, Ottawa ON K1A 0K2
Telephone: 1-800-883-6094 / Fax: 1-613-971-0114
Or electronically at: NationalMilitaryCemetery-CimetiereMilitaireNational@forces.gc.ca

DND 2277-E (05-2018) CLF 2.0
Design: Forms Management 613-901-6396 / 613-901-6397

Formulaire disponible en français - DND 2277-F