Application

Toll Free1-855-BRAVE-GI

(272-8344)

Approx date of end of service ? *

PLEASE , WE ASK THAT YOU SUPPLY US WITH A GOOD EMAIL ADDRESS,
AS THIS WILL BE OUR PRIMARY WAY TO CONTACT YOU FOR INSTALLATION ANNOUNCEMENTS AND QUESTIONS

Phone number *

Did SM attend Visalia school ?:

Contact person email: *

What Visalia school ?:

Comments: *

Secondary contact person's address:

Contact person last name: *

SERVICE MEMBERS APPLICATION

please make your checks or money orders payable to:

AMERICAN LEGION POST #18

Service Person's First Name: *

2nd Contact person's email: *

Contact person first name: *

Address Street 1: *

Phone:

Secondary contact person Name:

THIS IS
THE BRAVEPROJECTVISALIA.ORG

Service Person's Last Name and Sir name ie. Jr, Sr II, III *

Branch of Service: *

City & zip *

Has SM completed Boot Camp ?: *

What year did SM graduate:

SERVICE MEMBERS (SM) CONTACT INFORMATION

MUST BE CURRENTLY SERVING FROM VISALIA TO QUALIFY

*please note service members families are responsible for replacement costs when a banner becomes tatter or faded and has to be replaced*

PLEASE FILL IN ALL THE REQUIRED INFORMATION BELOW AS CORRECTLY

AS POSSIBLE (including date of discharge)

IF NOT FILLED COMPLETELY OUT YOUR APPLICATION CANNOT BE CONSIDERED

*By filling out the form below, you authorize the BRAVE PROJECT VISALIA to use any photos, images or likeness in any forum without compensation to those parties.*