Veteran Banner Registration Form
Name of Soldier
Serviceman / Servicewoman
Please Select One
Global War on Terror September 11, 2001 - Present
Persian Gulf War August 2, 1990 – August 31, 1991
Cold War September 2, 1945 – December 26, 1991
ietnam Era February 28, 1961 – May 7, 1975
Korean Conflict Era June 27, 1950-January 31, 1955
WWII December 7, 1941 - December 31, 1946
WWI April 6, 1917 - November 11, 1918
Civil War 1861 - 1865
Eras of Service | Official DOD dates
Is your Veteran:
Banner Sponsor Information
Address Line 1
District of Columbia
Names listed on the banner (at its bottom)
Relationship to Veteran
Click or drag files to this area to upload.
You can upload up to 2 files.
Please include a picture of your Veteran
Terms & Conditions
By checking this box I am hereby agreeing to the following:
I hereby grant the Medina, NY Hometown Hero Banner Program permission to use the attached/enclosed photo. The Medina, NY Hometown Hero Banner Program may use images of the banner in promotional materials without notification or additional permission. I take full responsibility that all information provided about the Veteran being honored is accurate and factual according to the 2022 Campaign Guidelines. I have read the 2022 Campaign Guidelines and I know that if the information is incorrect; or if any members listed in the bottom sponsorship section of the banner did NOT give their consent to be listed—the banner application will be null and void.
All Hometown Hero Banner Forms will be completed and mailed to Mary Woodruff 148 Elizabeth Street NY. Any questions or communication can be sent to email@example.com. All checks ($200 per banner) must be payable to the Village of Medina Clerk Jada Burgess. Please write Hometown Hero Banner in the memo section of your check.
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