Below is our Veterans Honoree form.  When click the SUBMIT button at the bottom, the form will be emailed to us to let us know that you wish to register.  You should print 2 copies of this page.  Keep one for your records, and mail the other with your payment or payment and photo to:

43rd Memorial Project,  PO Box 7281,  Berlin, CT  06037

Top of form is your contact information.

Bottom of form is the Veterans information.

Please check off either the Text Only box, or the Text with Photo box.  Please make checks payable to:  43rd Assn. Memorial Project.

Click on Search button on right to see what others have sent in.

Photo should be head & shoulders shot for best reproduction.  Please let us know if you wish your photo to be sent back to you.  We only return photos on request.

If you wish to email your photo, please be sure it is a jpg file extention only.  Photo should be a minimum of 200dpi to insure a sharp photo.  Email photos to: admin@43rd-idm.org

Please print 2 copies of this page before closing page.

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Search for Veterans by Name

*First Name
*Last Name
*Address
*City
*State
*Zip
Email
*Name of Honoree
Branch of Service
Hometown
Honored by:
Service Unit (s)
*Campaigns - Activity
Medals - Awards
Text only submition $15.00
Text with photo $25.00