Please fill out this form completely. Thank you for interest in Roll Call.
Date of Birth (mm/dd/yyyy):
Are you a veteran?YesNoIf yes, please fill out the next section. If not, skip to last section.
Branch of Service:
Date of Service:
Era of service:WWII, Korea, Vietnam, Cold War/Peace Time, Desert Storm/Shield, etc.
Rank at Discharge:
Division or Unit:
Battles or Engagements: