Fillable REQUEST FOR INCLUSION COLD WAR, SOUTHWEST ASIA AND (Boone County, Missouri)

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REQUEST FOR INCLUSION COLD WAR, SOUTHWEST ASIA AND (Boone County, Missouri)

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REQUEST FOR INCLUSION
COLD WAR, SOUTHWEST ASIA AND GLOBAL WAR ON TERRORISM
MEMORIAL MONUMENT
In March, 2016, a monument honoring all who served in the Cold War,
Southwest Asia and the Global War on Terrorism, as well as those who made
the ultimate sacrifice in those conflicts, was placed on the Boone County
Courthouse Plaza. At the time of its placement, the monument contained the
names of three individuals but with the knowledge that the names of others
may be added to the list.
Eligibility for individual inclusion on the monument is as follows:
• A veteran within the scope of the Monument
• A Boone County resident at the time of entry into active duty, or at the
time of their death
• Death occurred as a result of enemy action.
Documentation as to all of these criteria must be provided to the County
Commission by the person or organization requesting that an individual’s
name be added to the monument. Complete and verifiable documentation
must be received before any individual’s name will be added. Documentation
may be obtained from the Department of Veterans’ Affairs and is to include a
DD-214.
Name of applicant:
Name of service member:
Eligibility Criteria:
1. County of Residence at time of entry into active duty or at time of death:
2. Conflict for which eligibility is sought:
3. Cause of death:
(Documentation supporting criteria 2 and 3 may be obtained from the
Department of Veterans’ Affairs and is to include a DD-214).
CONTACT INFORMATION FOR PERSON MAKING APPLICATION:
Address:_____________________________________________________________________
Telephone:___________________________________________________________________
VERIFICATION:
The undersigned, the person making this application, hereby states upon their
oath that the information contained herein is true and correct to the best of
their knowledge and belief.
Signed: __________________________________________________, Applicant
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REQUEST FOR INCLUSION COLD WAR, SOUTHWEST ASIA AND (Boone County, Missouri)

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Completed 20 August 2020

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