Nomination Correction Form

Nomination Correction Form
Nomination Correction Information:

Please fill out the form below with the original proof of service.

ACCEPTED PROOF OF SERVICE:
- DD214 or Notice of Separation (front and back)
- Discharge Papers
- VA Health ID Card
- VFW or American Legion Membership Paperwork (honorable discharge)
- Funeral Home Documentation
- Newspaper Articles (including picture and service info)
- Statement of Service for current active members
- Copy of Military orders with service info
*If you have proof that is not on this list, reach out using the contact form.

TO OBTAIN DD-214 AS PROOF OF SERVICE:

To obtain a copy of DD Form 214 (Report ofSeparation), veterans, or their next of kin if the veteran is deceased, may either use the “eVETrecs”system or fill out and mail a SF Form 180 (Request Pertaining to Military Records) to theNational Personnel Records Center.

Detailed directions for both options are located at: www.archives.gov/veterans/military-service-records/

Records may also be available from the county Veterans Affairs (VA) office to which the veteran returned after leaving US Military Service.

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What needs to be fixed? Give a brief explanation to include the incorrect information so we can find it in our database. Then fill in the correct information using the form.
What do we need to fix?
Veteran's Full Name*

First NameMiddle InitialLast Name
Nickname
Format Options To Display Maiden Name:
- Maiden Last Name, First, MI
- Maiden Last Name (Married Last Name), First, MI
- Married Last Name (Maiden Last Name), First, MI
Branch of Service (Choose only one)*

ArmyAir ForceNavyMarine CorpsCoast GuardArmy Air CorpsMerchant MarineOther
Highest Rank Attained - DO NOT use pay grade *
(Examples: SGT or Sergeant; CPT or Captain)
MIA or KIA? (skip if neither)

MIAKIA
Years of Service
Year Entered* to Year Exited*
Name of Nominator (required)*
This can be yourself
Nominator Contact Information:

Only email address required.
Email Address*
example@example.com
Please select the box below to be added to the Veterans Plaza newsletter to hear about upcoming events at the Plaza.

I would like to be added to the newsletter
Phone Number (not required)
Add number if this is the best way to reach you.
Mailing Address (not required)
Add address if this is the best way to reach you.
Nominator's signature verifies that all information is true to the best of his/her knowledge, and that the veteran does not object to the listing of his/her name. See Page 2 for instructions on required proof of service.
Nominator Signature - Please Digitally Sign Below*

Clear
Today's Data*

MonthDayYear
Date
Nomination Status: You may check the status of nominations by visiting www.VeteransPlazaNoCo.org. Please allow four weeks processing time.

Donations: Please be aware that there is no charge for nominating a veteran. To support the Plaza with a tax-deductible donation, visit www.VeteransPlazaNoCo.org.

You may also make a check payable to the Community Foundation of Northern Colorado (write "Veterans Plaza" in the Memo field) and mail it to 4745 Wheaton Drive, Suite #100, Fort Collins, CO 80525.
Please Upload Proof Here*

Max Size: 5MB Accepts: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif
Cancelof
Note: When uploading documentation, please black out the veteran's Social Security Number and Service Number.

If none of the above forms of documentation are available, a paper application may be notarized as documentation. This application can be downloaded from the website: https://veteransplazanoco.org
Thank you for submitting your nomination correction. Please allow up to 2-weeks to see the correction.

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Should be Empty:

Nomination Correction Form

Nominator Contact Information: