test Last Name of Veteran *First Name of Veteran *Branch of Service *Check all that apply:Medal of HonorBronze StarPurple HeartPOWMIAAre They a Current or Past Huntington Resident?YesNoUpload a photo *Choose FileNo file chosenDelete uploaded fileYour Name: *Phone Number: *Email: *I hereby acknowledge that if my banner is not picked up within the 5 days of notification, I forfeit the right to my banner.Consent *I consent to the statement below. The undersigned confirms that he/she gives his/her permission to use his/her photograph, name, branch of service and other identifying information to be placed on a banner and displayed within the city. The undersigned agrees to provide a photograph suitable for such purposes. For those former service members who have passed away, the undersigned states that he or she is the next of kin to the identified honored person and does hereby consent to the use of the person's photograph, name, branch of service, and other identifying information in furtherance of the project. For those having a conservator or power of attorney, the undersigned states the he/she is the conservator or power of attorney for the honored person and does, serving in the said capacity, give consent on behalf of the honored person and does, serving in said capacity, give consent on behalf of the honored person for the use of a photograph, name, branch of service and identifying information for the subject project.Submit
