Veteran General Recognition

For veterans who are not nominating themselves or others for an award but would still like to receive Congressional recognition for their military service.

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Who is completing this registration?

I am the veteran, registering myself.

I am registering another veteran.

I am registering a veteran who is deceased or cannot attend

Nominator Information

Nominator's Name

First

Middle

Last

Your Relationship to the Veteran

Nominator Phone Number

Nominator Email

Veteran Information

Veteran's Name

First

Middle

Last

Preferred Name/Nickname

Date of Birth

Veteran Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

Military Service

Branch of Service

Component

Highest Rank Held

Final Certification

I certify that the information provided in this nomination is accurate to the best of my knowledge.

I understand that submitting a nomination does not guarantee selection or recognition during the Veterans Recognition Ceremony.

I understand that the Office of Congresswoman Shontel Brown may contact me or the nominee to request additional information or documentation necessary to evaluate this nomination.

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