City of Antioch Veterans Memorial BannerApplication
The City of Antioch in conjunction with Antioch VFW post 6435 and the Antioch VFW Auxiliary post 6435 will be displaying Veterans Memorial Flags on L St from 10th St to the Veterans Memorial at the end of L St..
Veteran Honoree must have lived in the City of Antioch and Must have an Honorable Discharge!
INSTRUCTIONS:
Family Members must complete this application, submit a photo of the Honoree (at least 300 dpi) and mail in all associated fee’s to:
Antioch VFW Post 6435
C/O Veterans Service Officer
815 Fulton Shipyard RD.
Antioch, CA 94509
Applicant’s Information
1. Name:
Last______First______Middle______
2. Address:
Number Street______Apt./Space/Ste. ____
City______State______ZIP Code______
3. Telephone:
Primary Number______Alternate Number______
4. Email:
Primary Address______Alternate Address______
5. Relationship to Honoree:______
Veteran Honoree Information
1. Name:
Last______First______Middle______
2. Date of Birth:______Date of Death (Age)______(___)
3. Branch of Service:
U.S. Army____ U.S. Marine Corps____ U.S. Navy____ U.S. Air Force____ U.S. Coast Guard____
OTHER:______
4. Rank:______Unit:______
5. Period(s) of Military Duty:
Entrance______Exit______
6. War Service:
World War I____World War II____ Korea___ Vietnam____ Persian Gulf____ Afghanistan____Iraq______Other:______
7. Awards:______Medal(s):______
Veterans MemorialBanner Flying Protocol
Veterans Memorial Bannerswill be flown the length of L St. from 10th St. north to the Veterans Memorial at the entrance of the Marina. A total of 34 Memorial Banners will be hung. The Memorial Banners will hang until it is torn or worn at which time the Banner will be retired by the Antioch Veterans Community with dignity and respect, the applicant will be notified at that time.
Fee
Veterans Memorial Banner: $350.00 each ($100.00 (VFW) + $50.00 (A.L.) + $50.00 (DVG) + $150.00 (Applicant))
$150.00 Must be received by the Applicant prior to making of Banner
Signature:______
Printed Name:______
Antioch VFW and Auxiliary Post 6435 Antioch American Legion Post 161 Delta Veterans Group
group.org
City of Antioch Veteran Memorial Flag Application presented by the Antioch VFW and its Auxiliary post 6435 Ver. 1.7 2- 7-2018