Veteran's Pinning Ceremony Registration Form

Veteran's Pinning Ceremony Registration Form

Submit by June 16, 2026 to be Honored
Pinning Ceremony The Station on 6th, 500 E. Cherry Street, Cottonwood Begins at June 26, 2026 at 1:30 pm
Veteran's Name

First NameLast Name
Rank
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date

MonthDayYear
Date
Phone Number

Area CodePhone Number
E-mail
Did you serve on active duty?
Did your service include combat or traumatic assignments
Did your spouse serve on active duty?
In which branch of the military did you serve?
In which war era or period of service did you serve?
Spouse or Gold Star Family of Veteran (may be present to accept honor in place of Veteran)
Spouse or Family Member's Name
Please verify that you are human
Should be Empty: