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Submit a Name to Honor Hazlet Heroes

2. 
4. The Township of Hazlet, in partnership with Hazlet PBA 189 and VFW Post 4303, is launching a special outdoor banner display called "Honor Hazlet Heroes." We wish to honor Hazlet residents currently serving in the military. We also are looking for the names of residents who served as well as those who died in service to our country. Banners honoring our Hazlet heroes will be displayed Memorial Day through Veterans Day 2021 on the lamp posts at Veterans Park, next to Town Hall. Email any questions to Committeeman James "Skip" McKay, former Navy SEAL, at jmckay@hazletnj.org.
6. ELIGIBILITY
   An individual is eligible to participate if they have served in the Air Force, Army, Marines, Navy, Coast Guard, Merchant Marines (WWII) and Women Air Force Service Pilots (WWII). The individuals must also have lived in Hazlet at any time, past or present. Veterans must be honorably discharged. Additional documentation may be required.
8. HOW TO APPLY

   Please complete the online application with photo and press the submit button. (You do not have to print it out to send, we will receive a copy of your application when you press Submit.)

   Please mail a check for $100 with honoree's name on the memo line.
   The deadline to submit a name has been extended until June 18, 2021.

   
   

   
   

   For Active Military, make check payable to Hazlet PBA #189.

   
   

   Mail to:

   Honor Hazlet Heroes

   c/o Hazlet PBA 189

   PO Box 187

   Hazlet, NJ 07730

   
   

   
   

   For Veterans and Died in Service, make check payable to VFW Post 4303 

   
   

   Mail to:

   Honor Hazlet Heroes

   c/o VFW Post 4303

   18 Davern Ave.

   Hazlet, NJ 07730

   
   

10. Tell Us About the Honoree

    1. Actively Serving in Miltiary
    2. A Veteran
    3. A Veteran Who Died Honorably in Service to our Country
12. Exact Name to Appear on Banner*
13. Branch of Military*
15. Years of Service OR Conflict*
16. Recipient of Purple Heart? *

    1. Yes
    2. No
18. Years (Dates) While a Hazlet Resident*
19. Address While a Hazlet Resident*
21. Please Upload a Photograph of Honoree in Military Uniform
    High resolution preferred.
25. Your Relationship to Nominee

    1. Myself
    2. My child
    3. My parent
    4. My deceased family member
    5. My spouse
    6. Other
27. If Other is chosen, please describe:
29. Your Name*
30. Your Email Address*
32. Your Address*
34. Your Town*
35. State*
36. Zip Code*
38. Your Phone Number*
40. Questions or comments?
44. Electronic Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
46. I approve and authorize the use of my name and image or my family member’s name and image on an Honor Hazlet Heroes banner to be displayed in Hazlet. I confirm that I, or my family member, meet the eligibility requirements.
48. Electronic Signature*
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field