Veterans Census Form Use this form to submit changes or additional information to include in our Veterans List. Veteran or Active Duty - Full Name:* First Last War(s) or Conflict (s):Branch of Service:Years of Service:Date of Death (If Applicable):Rank Upon Leaving Service:Special Honors, Achievements or Medals:Person Submitting Information (If Different from Veteran): First Last Contact Email: Contact Phone:Comments:CAPTCHA