Veterans Memorial Sign-Up Form

Memorial Veterans Listing

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.

Name of Church, Family or Organization*
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*
Name
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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Memorial Veterans Listing

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