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Veterans Form

TOWN OF BROOKHAVEN
War Service Record of Longwood CSD Veterans

The Wars on Terror: Gulf War /Afghanistan / Iraq

Operation Desert Storm, Operation Enduring Freedom and Operation Iraqi Freedom

 

Please mail completed forms to: Mr. Victor Massian, Longwood JHS, 198 Longwood Road, Middle Island, NY 11953

Full Name    ____________________________________________________________________________
(Please print)                            Last                                             First                                              Middle

 Date and Place of Birth ___________________________________________________________________

Address at time of entrance into service_______________________________________________________

Current Contact Info (if different from above)__________________________________________________

*E-mail_____________________________ *Phone/Cell __________________________(*will not be shared)

Name of Father ___________________________   Maiden Name of Mother _________________________

 Pre-Service Employment/Trade/Occupation ___________________________________________________

_______________________________________________________________________________________

 Names of Schools Attended:

_____ Years at _______________ Elementary School;    _____ Years at _______________ Middle School;

_____ Years at _______________ Junior High School;    _____ Years at _______________ High School;

 _____Years at ______________________ College;         _____ Years at ____________________ Other

High school sports/activities/accomplishments ____________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

   
Date and place of Induction _______________________________________ Military Branch_____________

Date and place of Separation ______________________________________________________________

Military or Naval training, occupation, qualifications, etc. _______________________________________

______________________________________________________________________________________

______________________________________________________________________________________

 Regiment, Company, Battalion Group, Squadron, etc. __________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

_________________________________________________________________________________________

 Ranks/Promotions__________________________________________________________________________

_________________________________________________________________________________________

 Left Cont’l U.S. (Date) ________ From ________  on (boat)___________  Arrived at (place) ___________

Other Postings, Sailings: Give dates, ships, places___________________________________

______________________________________________________________________________________

______________________________________________________________________________________

Final Arrival U.S. (Date)_______ from (place)_______ on (ship) __________ At (place) ______________

List or Describe: Army, M.C. Air Force, Navy or C.G. Service: Stations, Engagements, Campaigns, Theatres of Operation, Vessels Served On, Aircraft Flown, Commanders Served Under, Enemy Encounters, etc.

____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

 Decorations, Citations, Ribbons, etc. _______________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Other information (marriage, children, post-service occupations, etc.)    ____________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Photograph(s) of Veteran included ____________   Will be returned

Please feel free to add any additional information you would like included in your Veterans Biography.

 

For more information or questions please contact pinfranco@longwoodcsd.com

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