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NOMINATION OF A VETERAN FOR RECOGNITION ON THE HERITAGE PARK HISTORY WALL NOTE: Only Service Men and Women Who Are, or Were Residents of Sunny Isles Beach Themselves, can be Nominated Please fill in all blanks and please type or print clearly. Full Legal Name of Nominee Branch(es) of Service of Nominee Date Nominee Began Service Date Nominee Ended Service Highest Rank Obtained By Nominee Birth Date of Nominee Date of Nominee’s Death (if applicable) Person Submitting the Nomination Phone Number of Submitter Address of Submitter Submitter’s Relationship to Nominee

Boxes below to be filled in by City of Sunny Isles Beach. Printed Name of City Employee Verifying the Nominee Verification of Sunny Isles Beach Residency of Nominee Verification of Military Service of Nominee Signature & Date by City Employee Making Verification

Describe method of verification and attach documentation

Describe method of verification and attach documentation

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