Reserve a Symbolic Dog Tag Please enable JavaScript in your browser to complete this form. – Step 1 of 2Submitter's Name *FirstLastSubmitter's Email *Submitter's Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeSubmitter's Phone *NextVeteran's Last Name *Veteran's First Name *Veteran's Middle Initial *Official Veteran Name Listing as it will Appear on the Memorial *Military Branch *Air ForceArmyCoast GuardMarinesNavyYears of ServicePlease list beginning and end years of service as 4-digit years.Special RecognitionsMedal of HonorDistinguished Service CrossNavy or Air Force CrossSilver StarPurple HeartNoneWas this veteran MIA, KIA, or a POW? *MIAKIAPOWNonePlease note, a dog tag will be provided free of charge for MIA, KIA and POW veterans.The symbolic dog tag will include a QR code accessing an online tribute page to share your veteran story via video and photos. More information for creating this page will be available soon. Please start collecting stories and photos for possible inclusion. View a sample veteran tribute page.Upload Discharge Records * Click or drag a file to this area to upload. Upload a copy of the veteran official discharge documentation. Need help locating discharge documentation? Visit the VA website to request your military records. Submit <– Return to the Add a Name to the Memorial page
