Veterans Memorial Application

Veterans who would like to be included on the granite tablets at the Vets Memorial in Riverside Park may complete and submit the application shown below. Engravings are done once per year in November so any new applications for engravings should be turned into the Village by October 1st of each year.
After submitting the application, please mail a $180.00 check or money order made payable to “Village of Antwerp” along with a copy of the veteran’s discharge paperwork, to Village of Antwerp, Attn: Vets Memorial, P.O. Box 1046, Antwerp, OH 45813

First Name

Middle Initial

Last Name

Phone Number

Email Address

Branch of Service

Date of Induction

Date of Discharge

Type of Discharge

Proof of Antwerp Local School District

Former / Current Address

Address 2

City

State

Zipcode

AHS Graduate - Class of

On which tablet would you like the name engraved?

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