Gloversville Hometown Heroes Registration

Gloversville Hometown Heroes Registration
Gloversville Hometown Heroes Registration Form
Veteran Name*

RankFirst NameMiddle NameLast NameSuffix
ArmyNavyMarinesAir ForceCoast GuardNational GuardReserves
Service Start Year*
Service End Year*
Hero Photo*

Only PNG, JPEG, or JPG files are able to be submitted.
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Medals Awarded
For a directory of military medals, please visit downtowngloversville.org/HometownHeroes
DD Form 214 Upload

All DD Form 214 submissions will be destroyed immediately following proper review.
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Sponsor Email*
example@example.com
Sponsor Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Sponsor Display*
Displayed as written
Preferred Location
Specific banner location requests will be determined on a first-come, first-served basis.
Additional Comments
Is there any special you would like to share about your hero?
Purchase Summary
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Hometown Hero Banner & Installation
18 x 36 personalized hometown hero banner and installation 5/28/21 - 5/27/22

$100 Quantity
Item subtotal:$0.00

Total

$0.00
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Gloversville Hometown Heroes Registration Form