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. _______________________________________

______________________________________________________________________________________

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

______________________________________________________________________________________

Promotions ____________________________________________________________________________

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

Other sailings, Give Dates, ships, places _____________________________________________________

______________________________________________________________________________________

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.

____________________________________________________________________________________

_____________________________________________________________________________________

Decorations, Citations, Ribbons, etc. _______________________________________________________

_____________________________________________________________________________________

Other information______________________________________________________________________

_____________________________________________________________________________________

Photograph of Veteran included ____________

Will be returned