Applicants Information

Veteran Information

Branch of service please check all that apply:

Served in please check all that apply:

Please read before signing:
By signing my name below, I agree that all the information provided above is correct. Failure to provide one or more of the requested items above may result in the denial of my application. I also give the Allen County Fiscal Court and the City of Scottsville permission to use the service member’s information, image, and likeness on the printed banner, city/county website, social media platforms, and publications. This signed agreement states that I have read and agreed to all terms set forth by the Hometown Heroes Banner Program.

Please include verification of military service such as DD214, SF180, etc., and a photo of the veteran to dennis@allencountykentucky.com. Photos must be clear and high-resolution to ensure quality display. Please do not take a photo of a photograph.
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Applicant signature:

If you are not a relative or next of kin please have them sign below to agree to terms listed above. Relative or next of kin signature:

If Veteran is still living, please have them sign below to agree to terms listed above: