Somerset County
Southwest Asia Veterans
Commemorative Medal Registration Form		  





The Somerset County Board of Chosen Freeholders cordially invites all current and former Somerset County, NJ residents who served in the U.S. military in Southwest Asia* to be honored during the American Veterans Traveling Tribute at North Branch Park in Bridgewater. To register, please complete this form by September 1, 2015.


Veteran's First Name
Veteran's Last Name
Street Address
Town
State
Zip Code
Daytime Phone
Evening Phone
EMail Address


*The person named above is/was a Somerset County, NJ, resident who served in the U.S. Armed Forces in support of Operation Desert Shield or Desert Storm between August 2, 1990, and November 30, 1995, in one or more of the following areas: Persian Gulf, Red Sea, Gulf of Oman, Gulf of Aden, that portion of the Arabian Sea that lies north of 10 degrees N latitude and west of 68 degrees E longitude, and the land areas of Iraq, Kuwait, Saudi Arabia, Oman, Bahrain, Qatar and the United Arab Emirates; or individuals serving in Egypt, Israel, Turkey, Syria and Jordan (including territorial airspace and waters) directly supporting combat operations between January 17, 1991 and November 30, 1995.

Please mail a copy of your service Report of Separation DD 214 or other proof of service to:

Medal Registration
Office of Volunteer Services
P.O. Box 3000 Somerville, NJ 08876-1262
 
If you are applying on behalf of a deceased veteran, please include the following contact information:


First Name
 Last Name
Street Address
Town
State
Zip Code
Daytime Phone
Evening Phone
EMail Address
Relationship To Veteran


VETERANS RECOGNITION

I will pick up my medal during the American Veterans Traveling Tribute at the Somerset County Park Commission’s North Branch Park on October 1, 2015, during the opening ceremony starting at 6:00 p.m.

Please check one:
YES (complete information & directions will be mailed or emailed to you)
NO (medal will be mailed to you after the event)

For further information, please call (908) 541-5720
 or email veteransmedal@co.somerset.nj.us