Veterans

Home > Veterans Form

Name *

First

Last

Date of Birth

Branch Of Service

Service Number

Rank

Date Entered Service

Date Exited Service

Location(s) of Service

Where Inducted

Current Address

Address Line 1

Address Line 2

City

State

Zip Code

Current Phone Number

Address When Inducted

Address Line 1

Address Line 2

City

State

Zip Code

Spouse and Children Names (Include Maiden Name of Spouse if Applicable)

Name of Parents (Please Include Maiden Name of Mother If Known)

Any Other Pertinent Information That You'd Like to Include

If Veteran Is Deceased, Please Include the Place of Burial

Would you like to have an interview with a society member regarding your military service so that we may document your experience?

Yes
No

We would also like to have a photo of the veteran (if available).

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

The Campbell County Historical and Genealogical Society is a 501(c)3 non-profit corporation.
Our Federal Tax ID is 61-1178122.
Thank You!