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To submit a request to participate in the Veteran of the Game program, please fill in the following information.
First Name
Last Name
Pronunciation
Current Mailing Address
City
State
Zip Code
Email
Home Number
Cell Number
Hometown
Choice of Team
Would You Like to be Honored Virtually, In Person Or In Memoriam?
Virtually
In Person
In Memoriam
Status
Please Choose...
Active Duty
Veteran
First Responder
Branch of Service
Please Choose...
US Navy
US Marines
US Army
US Air Force
US Coast Guard
Rank
Please Choose...
ARMY - Private (Recruit)
ARMY - Private
ARMY - Private First Class
ARMY - Specialist
ARMY - Corporal
ARMY - Sergeant
ARMY - Staff Sergeant
ARMY - Sergeant First Class
ARMY - First Sergeant
ARMY - Master Sergeant
ARMY - Command Sergeant Major
ARMY - Sergeant Major
ARMY - Sergeant Major of the Army
ARMY - Warrant Officer 1
ARMY - Warrant Officer 2
ARMY - Warrant Officer 3
ARMY - Warrant Officer 4
ARMY - Master Warrant Officer 5
ARMY - 2nd Lieutenant
ARMY - 1st Lieutenant
ARMY - Captain
ARMY - Major
ARMY - Lieutenant Colonel
ARMY - Colonel
ARMY - Brigadier General
ARMY - Major General
ARMY - Lieutenant General
ARMY - Army Chief of Staff
ARMY - General
AIR FORCE - Airman Basic
AIR FORCE - Airman
AIR FORCE - Airman First Class
AIR FORCE - Senior Airman
AIR FORCE - Staff Sergeant
AIR FORCE - Technical Sergeant
AIR FORCE - First Sergeant (Master Sergeant)
AIR FORCE - Master Sergeant
AIR FORCE - First Sergeant (Senior Master Sergeant)
AIR FORCE - Senior Master Sergeant
AIR FORCE - First Sergeant (Chief Master Sergeant)
AIR FORCE - Chief Master Sergeant
AIR FORCE - Chief Master Sergeant of the Air Force
AIR FORCE - 2nd Lieutenant
AIR FORCE - 1st Lieutenant
AIR FORCE - Captain
AIR FORCE - Major
AIR FORCE - Lieutenant Colonel
AIR FORCE - Colonel
AIR FORCE - Brigadier General
AIR FORCE - Major General
AIR FORCE - Lieutenant General
AIR FORCE - Air Force Chief of Staff General
AIR FORCE - General of the Air Force
MARINE CORPS - Private
MARINE CORPS - Private First Class
MARINE CORPS - Lance Corporal
MARINE CORPS - Corporal
MARINE CORPS - Sergeant
MARINE CORPS - Staff Sergeant
MARINE CORPS - Gunnery Sergeant
MARINE CORPS - First Sergeant
MARINE CORPS - Master Sergeant
MARINE CORPS - Sergeant Major
MARINE CORPS - Master Gunnery Sergeant
MARINE CORPS - Sergeant Major of the Marine Corps
MARINE CORPS - Warrant Officer
MARINE CORPS - Chief Warrant Officer 2
MARINE CORPS - Chief Warrant Officer 3
MARINE CORPS - Chief Warrant Officer 4
MARINE CORPS - Chief Warrant Officer 5
MARINE CORPS - 2nd Lieutenant
MARINE CORPS - 1st Lieutenant
MARINE CORPS - Captain
MARINE CORPS - Major
MARINE CORPS - Lieutenant Colonel
MARINE CORPS - Colonel
MARINE CORPS - Brigadier General
MARINE CORPS - Major General
MARINE CORPS - Lieutenant General
MARINE CORPS - Commandant of the Marine Corps
MARINE CORPS - General
NAVY - Seaman Recruit
NAVY - Seaman Apprentice
NAVY - Seaman
NAVY - Petty Officer Third Class
NAVY - Petty Officer Second Class
NAVY - Petty Officer First Class
NAVY - Chief Petty Officer
NAVY - Senior Chief Petty Officer
NAVY - Master Chief Petty Officer
NAVY - Master Chief Petty Officer of the Navy
NAVY - Warrant Officer 1
NAVY - Warrant Officer 2
NAVY - Warrant Officer 3
NAVY - Warrant Officer 4
NAVY - Master Warrant Officer
NAVY - Ensign
NAVY - Lieutenant, Junior Grade
NAVY - Lieutenant
NAVY - Lieutenant Commander
NAVY - Commander
NAVY - Captain
NAVY - Rear Admiral (Commodore)
NAVY - Rear Admiral (Upper Half)
NAVY - Vice Admiral
NAVY - Chief of Naval Operations
NAVY - Commandant of the Coast Guard
NAVY - Admiral
NAVY - Fleet Admiral
COAST GUARD - Seaman Recruit
COAST GUARD - Seaman Apprentice
COAST GUARD - Seaman
COAST GUARD - Petty Officer Third Class
COAST GUARD - Petty Officer Second Class
COAST GUARD - Petty Officer First Class
COAST GUARD - Chief Petty Officer
COAST GUARD - Senior Chief Petty Officer
COAST GUARD - Master Chief Petty Officer
COAST GUARD - Master Chief Petty Officer of the Coast Guard
COAST GUARD - Warrant Officer 1
COAST GUARD - Warrant Officer 2
COAST GUARD - Warrant Officer 3
COAST GUARD - Warrant Officer 4
COAST GUARD - Master Warrant Officer
COAST GUARD - Ensign
COAST GUARD - Lieutenant, Junior Grade
COAST GUARD - Lieutenant
COAST GUARD - Lieutenant Commander
COAST GUARD - Commander
COAST GUARD - Captain
COAST GUARD - Rear Admiral (Commodore)
COAST GUARD - Rear Admiral (Upper Half)
COAST GUARD - Vice Admiral
COAST GUARD - Chief of Naval Operations
COAST GUARD - Commandant of the Coast Guard
COAST GUARD - Admiral
COAST GUARD - Fleet Admiral
Era Served In
Please Choose...
Still Active
Operation Iraq Freedom
Operation Enduring Freedom
Peace Time
Desert Storm Veteran
Operation Deliberate Force(Bosnia Veteran)
Cold War Era
Vietnam War Veteran
Korean War Veteran
World War II Veteran
Date of Military Service Beginning
Date of Discharge (If Applicable)
Do you have an Honorable Discharge
Yes
No
Military Awards and Decorations
Are You Receiving Department of Veterans Service Connection Disability Pay?
Yes
No
What Percentage Are You Currently Receiving?
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Would you be interested in a complementary review and counsel of your VA Compensation by a Professional Legal Team?
Yes
No
DD214 / Discharge Papers (If Applicable)
Submit A Minimum of Two Photos. One Photo Must Be a Recent Image Of The Veteran, And The Other Photo Must Be Of The Veteran During Military Service. Additional Photos Can Include More Military, Special Occasions, Family Photos, Etc.
I, The Veteran, Guardian, Or Personal Representative, Give Consent To Interviews, Photos, Videos, And Biographies Of The Veteran On Behalf Of Veteran Of The Game To Showcase On Their Social Media Platforms Including Instagram, Facebook, And YouTube.
Yes, I Give Consent.
No, I Do Not Give Consent.
Submit
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Step
1
of 2
Name
*
First
Last
Pronunciation
*
Address
*
Address Line 1
Address Line 2
City
--- Select state ---
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Layout
Email
*
Home Number
*
Mobile Number
Hometown
*
Choice of Team
*
Would You Like To Be Honored : Virtually, In Person, or In Memoriam?
*
Virtually
In Person
In Memoriam
Next
Layout
Status
*
Select Status . . .
Active Duty
Veteran
First Responder
Branch Of Service
*
Select Branch . . .
US Navy
US Marines
US Army
US Air Force
US Coast Guard
Rank
*
Select Rank . . .
ARMY - Private (Recruit)
ARMY - Private
ARMY - Private First Class
ARMY - Specialist
ARMY - Corporal
ARMY - Sergeant
ARMY - Staff Sergeant
ARMY - Sergeant First Class
ARMY - First Sergeant
ARMY - Master Sergeant
ARMY - Command Sergeant Major
ARMY - Sergeant Major
ARMY - Sergeant Major of the Army
ARMY - Warrant Officer 1
ARMY - Warrant Officer 2
ARMY - Warrant Officer 3
ARMY - Warrant Officer 4
ARMY - Master Warrant Officer 5
ARMY - 2nd Lieutenant
ARMY - 1st Lieutenant
ARMY - Captain
ARMY - Major
ARMY - Lieutenant Colonel
ARMY - Colonel
ARMY - Brigadier General
ARMY - Major General
ARMY - Lieutenant General
ARMY - Army Chief of Staff
ARMY - General
AIR FORCE - Airman Basic
AIR FORCE - Airman
AIR FORCE - Airman First Class
AIR FORCE - Senior Airman
AIR FORCE - Staff Sergeant
AIR FORCE - Technical Sergeant
AIR FORCE - First Sergeant (Master Sergeant)
AIR FORCE - Master Sergeant
AIR FORCE - First Sergeant (Senior Master Sergeant)
AIR FORCE - Senior Master Sergeant
AIR FORCE - First Sergeant (Chief Master Sergeant)
AIR FORCE - Chief Master Sergeant
AIR FORCE - Chief Master Sergeant of the Air Force
AIR FORCE - 2nd Lieutenant
AIR FORCE - 1st Lieutenant
AIR FORCE - Captain
AIR FORCE - Major
AIR FORCE - Lieutenant Colonel
AIR FORCE - Colonel
AIR FORCE - Brigadier General
AIR FORCE - Major General
AIR FORCE - Lieutenant General
AIR FORCE - Air Force Chief of Staff General
AIR FORCE - General of the Air Force
MARINE CORPS - Private
MARINE CORPS - Private First Class
MARINE CORPS - Lance Corporal
MARINE CORPS - Corporal
MARINE CORPS - Sergeant
MARINE CORPS - Staff Sergeant
MARINE CORPS - Gunnery Sergeant
MARINE CORPS - First Sergeant
MARINE CORPS - Master Sergeant
MARINE CORPS - Sergeant Major
MARINE CORPS - Master Gunnery Sergeant
MARINE CORPS - Sergeant Major of the Marine Corps
MARINE CORPS - Warrant Officer
MARINE CORPS - Chief Warrant Officer 2
MARINE CORPS - Chief Warrant Officer 3
MARINE CORPS - Chief Warrant Officer 4
MARINE CORPS - Chief Warrant Officer 5
MARINE CORPS - 2nd Lieutenant
MARINE CORPS - 1st Lieutenant
MARINE CORPS - Captain
MARINE CORPS - Major
MARINE CORPS - Lieutenant Colonel
MARINE CORPS - Colonel
MARINE CORPS - Brigadier General
MARINE CORPS - Major General
MARINE CORPS - Lieutenant General
MARINE CORPS - Commandant of the Marine Corps
MARINE CORPS - General
NAVY - Seaman Recruit
NAVY - Seaman Apprentice
NAVY - Seaman
NAVY - Petty Officer Third Class
NAVY - Petty Officer Second Class
NAVY - Petty Officer First Class
NAVY - Chief Petty Officer
NAVY - Senior Chief Petty Officer
NAVY - Master Chief Petty Officer
NAVY - Master Chief Petty Officer of the Navy
NAVY - Warrant Officer 1
NAVY - Warrant Officer 2
NAVY - Warrant Officer 3
NAVY - Warrant Officer 4
NAVY - Master Warrant Officer
NAVY - Ensign
NAVY - Lieutenant, Junior Grade
NAVY - Lieutenant
NAVY - Lieutenant Commander
NAVY - Commander
NAVY - Captain
NAVY - Rear Admiral (Commodore)
NAVY - Rear Admiral (Upper Half)
NAVY - Vice Admiral
NAVY - Chief of Naval Operations
NAVY - Commandant of the Coast Guard
NAVY - Admiral
NAVY - Fleet Admiral
COAST GUARD - Seaman Recruit
COAST GUARD - Seaman Apprentice
COAST GUARD - Seaman
COAST GUARD - Petty Officer Third Class
COAST GUARD - Petty Officer Second Class
COAST GUARD - Petty Officer First Class
COAST GUARD - Chief Petty Officer
COAST GUARD - Senior Chief Petty Officer
COAST GUARD - Master Chief Petty Officer
COAST GUARD - Master Chief Petty Officer of the Coast Guard
COAST GUARD - Warrant Officer 1
COAST GUARD - Warrant Officer 2
COAST GUARD - Warrant Officer 3
COAST GUARD - Warrant Officer 4
COAST GUARD - Master Warrant Officer
COAST GUARD - Ensign
COAST GUARD - Lieutenant, Junior Grade
COAST GUARD - Lieutenant
COAST GUARD - Lieutenant Commander
COAST GUARD - Commander
COAST GUARD - Captain
COAST GUARD - Rear Admiral (Commodore)
COAST GUARD - Rear Admiral (Upper Half)
COAST GUARD - Vice Admiral
COAST GUARD - Chief of Naval Operations
COAST GUARD - Commandant of the Coast Guard
COAST GUARD - Admiral
COAST GUARD - Fleet Admiral
Era Served In
*
Select Era . . .
Still Active
Operation Iraq Freedom
Operation Enduring Freedom
Peace Time
Desert Storm Veteran
Operation Deliberate Force(Bosnia Veteran)
Cold War Era
Vietnam War Veteran
Korean War Veteran
World War II Veteran
Date Military Service Began
*
Date of Discharge (If Applicable)
Do you have an Honorable Discharge?
*
Yes
No
DD214 / Discharge Papers (If Applicable)
*
Click or drag files to this area to upload.
You can upload up to 2 files.
Please List All Military Awards and Decorations
Layout
Are You Receiving Department of Veterans Service Connection Disability Pay?
*
Yes
No
What Percentage Are You Currently Receiving?
Select Percentage . . .
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Would you be interested in a complementary review and counsel of your VA Compensation by a Professional Legal Team?
*
Yes
No
Image Use Consent
Yes, I Give Consent.
No, I Do Not Give Consent.
I, The Veteran, Guardian, Or Personal Representative, Give Consent To Interviews, Photos, Videos, And Biographies Of The Veteran On Behalf Of Veteran Of The Game To Showcase On Their Social Media Platforms Including Instagram, Facebook, And YouTube.
Submit A Minimum of Two Photos
*
Click or drag files to this area to upload.
You can upload up to 6 files.
One Photo Must Be a Recent Image Of The Veteran, And The Other Photo Must Be Of The Veteran During Military Service. Additional Photos Can Include More Military, Special Occasions, Family Photos, Etc.
Submit
