The collecting of names for the Wall is an on-going task.  While the initial name plaques are in place, it is the Committee's goal to add new names each year as previously unreported veterans' names become known and as new veterans become eligible.

You can help.  If you are a veteran who qualifies or if you know of a veteran who qualifies, please complete the form below.

Veteran information:

Active veteran during the: (Please check all that apply)

Revolutionary War Civil War World War I World War II
Korean War Vietnam Gulf War Iraq / Afghanistan

                     

Name of veteran:      Branch:      Rank:

Street:     City:     State:     Zip:     Phone:

Killed in action     Died from non-combat-related reason     Picture available

Please note any medals, citations, etc. that vet may have received:

Provider information:

Info provided by:      Provider phone:

Other information:

If you make a mistake, you can press the Reset button below to clear all of the fields.  When you are ready to send the form to us, press the Submit button JUST ONCE.  There will be a slight delay before you receive an acknowledgment that your form has been sent.