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Honor A Deceased Veteran Application

  1. APPLICATION FOR RENSSELAER COUNTY HONOR-A-DECEASED VETERAN

    Please elaborate on all information concerning the Veteran so that we may have a full biography for our pamphlet and ceremony. 

    Please complete all fields on application, please DO NOT write “See Obit”.  All fields are required, use "N/A" if needed.

    Submitted applications must be accompanied by a copy of Veteran’s Report of Separation/DD-214 or Report of Casualty and a copy of Veteran’s obituary.

    For questions, please call the Rensselaer County Veterans Service Agency (518)270-2760.

  2. VETERAN INFORMATION (please complete all fields)

  3. FAMILY CONTACT INFORMATION (please complete all fields)
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  5. This field is not part of the form submission.