HALL of HEROES
INDUCTION
NAME of INDUCTEE: _______________________________________________
BRANCH: _________________________________________________________
DATES of SERVICE: ________________________ - ______________________
PHONE: ___________ - ___________ - ___________ home / work / cell (preferred)
___________ - ___________ - ___________ home / work / cell (other)
E-MAIL: __________________________________________________________
PHOTO: yes / no
CONNECTION to BUCKHORN HS (relative, etc): __________________________
__________________________
ANY ADDITIONAL INFORMATION (medals, honors, etc):
________________________________________________________________
________________________________________________________________
All checks payable to Buckhorn High School in care of Buckhorn Historical Society.
