For those veterans and their families who are looking to be recognized in for their service to our country. Please complete this form. You will be notified prior to the next event being held in the Spring of 2018 and we hope you attend.

Veteran’s Name_________________________________________________________
Veteran’s Address ________________________________________________________
Telephone number and email address_________________________________________
Branch of Service___________________________ Years Served______________________
Rank______________________________________________________________________
Conflict Served –Circle those you served during.
Spanish American War Phillippine Insurrection World War I World War II Korean War Vietnam War Desert Storm Afghanistan War Iraq War Enduring Freedom OTHER___________________
Thank you for your service to our country.

If we are honoring this veteran in memory- Please provide the name, address and telephone number of
the family member attending and receiving recognition. __________________________________________________________________________

__________________________________________________________________________

Please send form via email to LHHV Executive Director, Ron Shawley
at [email protected] or by US Mail to 172 Allbaugh Park Road, Johnstown, PA 15909. If you have any questions, call 814-241-6123