Quilts of Valor nomination form

Nomination for a Quilt of Valor

We have three quilts to be awarded at the Military Appreciation Breakfast Saturday, Nov. 2, at the Ware Senior Center. The nominee must be a military service member or veteran who has been touched by war. The person should be from the Ware-Palmer geographical region. If you do not know the nominee’s contact information, you may leave it blank.
Your Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please provide either a phone number or email address.
Phone Number

Area CodePhone Number
E-mail
Name of Nominee

First NameLast Name
Please provide either an email address or phone number for your nominee, if you know it. Otherwise, leave it blank.
Email address
Email
Phone number

Area CodePhone Number
Branch of service
Number of years in service
Should be Empty:

Nomination for a Quilt of Valor