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:
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