If the Vietnam-era veteran is being awarded posthumously, please provide the full name of the family member and relation to the veteran who will be accepting the pin on his or her behalf
Birth date of veteran
Branch of Military Service
Dates of Service
Location(s) of Service
Is there any other information you can share about the veteran, such as their rank, their military occupation, or a brief story?
If you are submitting a nomination on behalf of a veteran, please provide your contact information below:
Name of person completing this nomination
Your relation to the veteran
Your phone number
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