| Name:* |
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| Address: |
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| E-Mail Address:* |
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| Have you served in the Armed Forces?: |
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| Date of Discharge (mm/dd/yyyy): |
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| Are you an un-remarried spouse of a deceased U.S. Veteran?: |
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| Do you have a copy of your DD214 form?: |
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| Member of DAV: |
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| Member of American Legion: |
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| Member of VVA: |
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| Reservation Starting Date: |
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*Please view the pricing table below before submitting for reservation.
* If paying by credit card, please submit the form, then call us at 651-433-2699 with your credit card information.
* If paying by check, please print the confirmation screen and mail it along with your check. |
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