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Korean War Veteran's form

TOWN OF BROOKHAVEN
War Service Record of Veterans of the Korean War
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________________________________________________

 Name of Father ___________________________________________________________________

 Maiden Name of Mother ____________________________________________________________

 Employed by before entering service __________________________________________________

 Trade or Occupation _______________________________________________________________

 Names of Schools Attended:

 _______ Years at ________________________________________ Primary School

 _______ Years at ________________________________________ High School

 _______ Years at ________________________________________ College

 _______ Years at ________________________________________ Other

   
Date and place of induction ___________________________________________Branch_____________

 Date and place of Separation ______________________________________________________________

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

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

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 Promotions ____________________________________________________________________________

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

 Other sailings, Give Dates, ships, places _____________________________________________________

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

 Army or M.C. Service: Engagements, Campaigns, Theatres of Operation, etc.

Navy of C.G Service: Stations, Vessels served on, Enemy Encounters, etc.

____________________________________________________________________________________

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 Decorations, Citations, Ribbons, etc. _______________________________________________________

_____________________________________________________________________________________

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_____________________________________________________________________________________

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 Other information______________________________________________________________________

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 Photograph of Veteran included ____________

Will be returned

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