FALLEN SUBMISSION FORM

Fallen Service Member Information
(mouse over field names for help)
 
First Name Nominations
Last Name The primary purpose of the organization is to care for and improve the Fallen Warrior Memorial in order to remember and honor those that have made the ultimate sacrifice in service to the United States of America. Primary improvements will be the addition of plaques in honor of the fallen. Submissions in keeping with all of the following guidelines will be accepted throughout the year:

1. Qualification 1 - Died in combat as determined in US Code Title 26, Subtitle B, Chapter 11, Subchapter C, 2001, quoted here as:

1.1 Any citizen or resident of the United States dying while in active service of the Armed Forces of the United States, if such decedent -

1.1.1 was killed in action while serving in a combat zone, as determined under section 112 (c), or

1.1.2 died as a result of wounds, disease, or injury suffered while serving in a combat zone (as determined under section 112 (c)), and while in the line of duty, by reason of a hazard to which such decedent was subjected as an incident of such service

2. Qualification 2 Born in Nebraska or the 100 miles surrounding Offutt Air Force Base Nebraska OR stationed at Offutt Air Force Base, Nebraska at time of death
Middile Initial
Service
(abbreviated)
Rank
(abbreviated)
Duty Station
Birthplace
Date of Death
(format 2011-01-01)
Submitter Information
POC Name
POC Phone
POC E-Mail
Short Bio