Litchfield Illinois
Veterans' Memorial Project
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Veteran's registration form:
Veteran's Name
Your Name: (if different from above):
Address:
City: State: Zip:
Phone:
E-Mail Address:
School District:
Branch of Service:
Service Era:(NOTE: If a veteran was in the span of two eras, it will be up to him to specify which era he wants to be listed under.)
Month/Year Entered Service:
Month/Year of Discharge:
Is the DD214 on file at the Montgomery County Clerk's office Yes No Unknown
Other Information:
This form is to gather information for a contact list only. Verification of data will be required prior to inclusion of the veteran's name at the memorial. It is highly recommended that a copy of your DD214 be filed with the Montgomery County Clerk's office in Hillsboro, Il.