Veteran Pinning Ceremony

We are honored to host the Vietnam Veterans 50th Anniversary Pinning Ceremony. Please fill out this form to RSVP for the event. It will be held on November 7^th at 2:00 p.m. in the Pelham Civic Complex. A formal invitation will be emailed following your RSVP. We look forward to meeting all of you! If you have any questions, please call our district office at (205) 968-1290.

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Please complete this form to register for our Veterans Recognition Event. We honor the service and sacrifice of our military veterans and their families.

Your Contact Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Address

Address 2

City/Town

State

ZIP Code

Email:

Birthday:

Contact Phone Number:

Phone Number

Phone Type:

What are these options?

Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option 'Voice' is a standard audible telephone.

Military Service Information

Branch of Service:

Military Rank:

Years of Service:

Please list military medals, awards or decorations:

Event Details

How many people will be attending the event with you?

Is the Veteran deceased?

Yes

Pin Recipient Information

Please provide the information for the person who will be receiving the pins.

First Name:

Last Name:

Relationship to the Veteran:

Please list the name of the spouse or child that will be receiving the pins on behalf of the Veteran:

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