Beirut Memorial On Line

1. Email Address:
Email must only be in the form username@domain.type Example: smith@aol.com Otherwise, you will not get a confirmation email of your submission.
2. Full Name:
The format for this is First Last (Examples: John Smith, Jane Doe)
3. Residence:
(optional) Where you are currently living? i.e. Chicago, IL

4. Rank at the Time / Current Rank (if applicable)		5. Rank at EOS / Rank at RET (if applicable)
6. Time of Deployment From - To (if applicable)		7. Unit in Beirut, Lebanon (if applicable)
8. Branch of Service		9. How did you hear about this site?
10. Are you currently a member of the Beirut Veterans of America? YES NO
11. Your association with the event? (Format: Lebanon Vet, relative of deceased (please include name)
12. Comments/Questions/Feedback
13. Would like to be on our e-mailing list? YES (Leave this checked if you do) (NOTE: This item refers to periodic e-mails of items of interest and you will be able to unsubscribe at any time, as the information will be included in each email.)
14. Would you like to be carried under the PEOPLE & CONTACTS section of this site? YES NO

URL: http://www.beirut-memorial.org/people/form.html
This site is under constant ongoing evolutionary change.
Created 06/21/97 | Last Modified 07/04/2000

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