Add a Veteran’s Name for Engraving – FORM | Northwestern Lehigh Veterans Memorial

Submit a Veterans Name for Engraving

New names may be added in the spring of each year before Memorial Day. The cut-off-date for submitting this form for engraving new names is December 31.

There is no fee to add a Veterans name for engraving. However, the actual cost is $125 for each name, any donation towards the engraving cost would be appreciated and can be made under the DONATIONS tab above.

Please provide the NAME and information of the Veteran as it should appear on the Memorial. Please enter all known information. Check KIA if killed in action or on duty. List the War or Year(s) Served, for example: WW-II or1941-45.

If you are having trouble completing this form please email us at nwlehighvetsmemorial@gmail.com we will contact you with assistance.

Veteran's Name*
Prefix First Middle Last Suffix
Date of Birth*
MM slash DD slash YYYY
Highest Rank*
Branch of Service*
Years of Service*
War or Theatre*
Killed In Action*
Township*
- Heidelberg
- Lowhill
- Lynn
- Weisenberg
Township of Residence
Personal Remarks of Veterans Service*
Your Name*
First Last
Your Email Address*
Phone Number*
Comments
This field is for validation purposes and should be left unchanged.

If you wish to do this in print, please complete the linked form below. Print the NAME of the Veteran as it should appear on the Memorial. Please enter all known information.

Check KIA if killed in action or on duty. List the War or Year(s) Served, for example: WW-II or 1941-45.

Use abbreviations for Township of residence: Heidelberg (H), Lowhill (LH), Lynn (LN) or Weisenberg (W).

Veterans Memorial Form

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Add a Veteran’s Name for Engraving – FORM

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