Vietnam War 50th Commemoration Application Form

There are more than 200,000 veterans in Washington state who served during the Vietnam War. Congresswoman DelBene will be honoring these heroes, including unreturned veterans, and their families at Vietnam War 50th Commemoration pinning ceremonies.

DelBene is partnering with the Vietnam War Commemoration as part of a nation-wide effort to thank and honor all Vietnam-era veterans, who are eligible to receive a Vietnam Veteran lapel pin, which DelBene will publicly present to recognize their service and sacrifice for our country.

The next pinning ceremony will be:

Thursday, March 29, 2018
10:00AM – 11:30AM
Skagit Valley College, Gary Knutzen Cardinal Center
2405 E College Way Mount Vernon, WA 98273

The Vietnam War Commemoration ceremony aims to:

  • Thank and honor veterans of the Vietnam War, including personnel held as prisoners of war (POW) or listed as missing in action (MIA), for their service and sacrifice on behalf of the United States, as well as the families of these veterans.
  • Highlight the service of the U.S. Armed Forces during the Vietnam War and the contributions of federal agencies and governmental and non-governmental organizations that served with, or in support of, the Armed Forces.
  • Pay tribute to the contributions made by those at home during the Vietnam War.
  • Recognize the contributions and sacrifices made by the allies of the United States during the Vietnam War.

If you or a family member served between Nov. 1, 1955, and May 15, 1975, and would like to participate in a pinning ceremony please complete this form BELOW. 

If you are an eligible Vietnam veteran in Washington state and are interested in receiving a Service Lapel Pin but cannot attend a ceremony in person, please contact Benjamin Studley in Congresswoman DelBene’s District Office at benjamin.studley@mail.house.gov or 425-485-0085.

Personal Information
First Name *
Middle
Last Name *

Family member name and relation: (If the Vietnam Veteran is being awarded posthumously, please list the name and relation of the family member accepting the pin on their behalf)

* Birth Date of Veteran (mm/dd/yyyy):
Phone Number:
* Email:
Where the confirmation will be sent
* Home Address:
* City:
* State:
 * Zip:
If you selected that you would like to attend a pinning ceremony, please select your preferred pinning ceremony date?
Thursday, March 29, 2018
Please contact me about future pinning ceremony dates when scheduled
Gender:
Male Female
Are You a U.S. Citizen?
Yes No
If not, list your country of citizenship:
Service Information
Branch of Military: *
Dates of Service: *
Location(s) of Service: *
Military Documentation: By submitting this form, I certify I am a Vietnam Veteran who served in the military from November 1, 1955 to May 15, 1975, at any duty station worldwide. I can provide a DD214, if asked, as proof of service during this time period.

Please include the names of guests who will be attending, as well as any other information you would like our office to know about you and/or your service:

Information submitted with your application cannot be returned. Information submitted with your application is subject ot the Privacy Act of 1974, 5 U.S.C Section 552(a), as amended and to the Freedom of Information Act, Section 552, as amended.

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