Veteran Banner Registration Form

Eras of Service | Official DOD dates
Check One
Banner Sponsor Information
Click or drag files to this area to upload. You can upload up to 2 files.
Please include a picture of your Veteran
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 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.