Military Instrumentalist's Endorsement Form

Military Instrumentalist's Endorsement Form
I understand that in order to establish greater credibility, Amerisong is asking individuals with military instrumentalist backgrounds to share their names and in-uniform pictures in support of the organization's mission, to "Honor our Veterans and Military, promote service, and foster patriotism and responsible citizenship through music, song, and by the example of its members".

I understand that there are no costs, obligations or responsibilities as an Amerisong military instrumentalist endorser, and that no further responsibility or commitment shall be asked or required of me. By submitting this form I agree to allow Amerisong, at its discretion, to use my name, military affiliation, instrumental specialty, and rank, publicly (online, in print, and otherwise), as a named supporter, endorser, and former military instrumentalist. Amerisong may also use my in-uniform picture in conjunction with my endorsement. I grant this permission on the condition that if at any time, or for any reason I wish to revoke it, upon my notification Amerisong will discontinue and remove all references to my endorsement.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
E-mail
Branch

ArmyMarinesNavyAir ForceCoast Guard
Years in the Military
Number of Years
From
Year Drafted or Enlisted
To
Year Discharged
Rank upon discharge
Abbreviation of your rank as it would appear before your name
Musical Group and Specialty
Description of Choral Group, Part, Band, Instrument, Etc.
Picture in uniform

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