- AGENT ORANGE VICTIMS HAVE AN ORANGE HEART -
You may use this form to provide information about a member of the U.S. Armed Forces that is not on our list or more information for a veteran we have listed and who died while on active duty of any cause while engaged in military operations or from disease or other actions not related to hostile events. You may also upload photos and documents about the veteran.
We need of people willing to do research to help us find casualty dates for many on our list as well as more information about all of the veterans.
Do not share information about the veteran that you do not want in the public domain.
Your name, address, contact information and relationship to the veteran is considered private and will NOT be shared with anyone without your permission.
If you are not sure your submission has the appropriate requirements or ties to Allen County to be included in our memorial, submit the information and we will make a decision based upon our established criteria. We will error on the side of inclusiveness. We will contact you if we need more information.
You may Leave any portions blank that do not have an * indicating it is required if you do not have the information. You may use the notes section to provide as much information as you wish. If you realize you forgot something or have more information about someone you already submitted, please check the "THIS IS AN UPDATE" box. Only fields marked with an asterisk * are required.
If you have suggestions for modifications to this form please include that in your notes or email us via our contact page "ContactUs"
Thank you for helping us honor your veteran friend or loved one. You will receive an automatic notice by email that we have received your submission.