William J. Donovan Purple Heart Recipients Book of Merit Form

If you are a Purple Heart Recipient living in Erie County or would like to nominate a Purple Heart Recipient (living or deceased), please fill out the application form below to be entered into the "William J. Donovan Purple Heart Recipients Book of Merit" for 2024.

Click here to download Purple Heart Recipients Form.

Purple Heart Recipient's First Name

Purple Heart Recipient's Middle Name/Initial

Purple Heart Recipient's Last Name

Conflict Served

Branch of Service

Please indicate if the veteran is deceased

Yes

Copy of Discharge Paperwork (listing Purple Heart Award)

One file only.
1.5 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.

Contact Name (if different from Purple Heart Recipient Name above)

Contact Complete Mailing Address

Contact Phone Number