> Deceased Veterans Burial Form -->

Deceased Veterans Burial Form
(Please fill in the details and click on the "Send Survey" box)

Your full Name Email * 

In the space below list the name of veteran from the Brunswick, Knoxville, Weverton, Sandy Hook, Petersville, Jefferson, Adamstown Pt of Rocks and Burkittsville area.  Burial can be anywhere.

Deceased veteran's Last Name First Name Middle Name or Initial

Served during War or Conflict Civil War  WW1  WW2  Korean  Vietnam  Other War or Conflict

Branch of Service Army Navy Marines Air Corps Coast Guard WAC WAVE Nurse   Other

Rank Div Regiment Company/Ship etc

Date enter service Date discharged

Date Born Date Died

Any other information
Where buried cemetery city state Sec Lot #