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Military Heroes Banner Request

Thank you for your interest in the “Military Heroes" Banner Program!
This form is designed to be used in conjunction with the towns/cities that we’ve been contracted by.  We do not sell or ship banners to individuals who are not affiliated with specific towns/cities.

For details on cost, specifications and dates, please contact the representative who is managing this program for your town.  

We only accept Amex, Mastercard, Visa and Discover as forms payment. 

(See payment link at the end of this form.)

If you are commemorating more than one individual, please fill out a separate form for each.

Proudly Honored By

Your Full Name

Your Billing Address

Your Mobile Number

Best Email

Best Contact Method

Name of Military Hero to be Commemorated

(First, Last and Middle Initial, if applicable)

Branch of Military

Era of Service

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Veteran's Status

Medals (Purple Heart / Silver Star / Bronze Star)

* If you require a different medal, please supply a high-resolution picture.

Photo Upload Section

Ensure photos submitted are in High Resolution.

• File should be a minimum of 300 dpi for a 4x6 photo while smaller photos should be scanned at 600-1200 dpi or greater.  

Ensure the File type is JPG, PNG or PDF format.
If you're unsure which image to choose, you can upload up to 3 and we will choose the best option. 

I understand that my application is not complete until payment has been received.

(See above for payment options)

We will email a receipt to the address you provided above.

I understand that my application is not complete until payment has been received.

Make Payment Here