APPLICATION TO THE VETERAN'S MEMORIAL
Please complete the following information for each name to be included on the honor roll. One name per form please.
Please Print your name and information.
Name (The way it should appear on plaque)
Rank - Branch of Service - Service Dates (years)
NOTE: ANY POINTS OF INTEREST CAN BE INCLUDED SUCH AS - KIA, POW,
PURPLE HEART, BRONZE STAR, ETC.
A minimum contribution of $35 per plaque is required, however, any additional
contribution to help defray other construction and upkeep costs would be greatly
appreciated. Your contribution is Tax Deductible.
Make checks payable to
Amount included: __________________________
Submitted by: _____________________________________
|Please return this form and payment to Manning VFW hall at:
201 Main Street
Manning, IA 51455
For more information please call: