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5. City of Oviedo Recreation and Parks

   
   

   Veterans Tribute - Wall of Honor Application Form

7. Name of Nominator
9. Address
11. City
12. State
13. Zip Code
15. Phone Number
17. Email Address
19. Note:

    All submissions must be received by August 1 in order to be considered for the current year's plaque.

23. Eligibility

25. Please Choose One:

    1. Active or honorably discharged military personnel of the Armed Forces
    2. Died in the line of duty as a member of the Armed Forces
27. Also include one or more of the following:

    1. Current city of Oviedo resident with a valid mailing address
    2. Relative of a current Oviedo resident (i.e. spouse, dependent, parents, grandparents, etc...)
    3. Current full-time employee with the City of Oviedo
    4. Relative of a current full-time employee with the City of Oviedo
    5. Current Member of the American Legion Oviedo Memorial Post 243

29. Any or all of the above may be subject to verification. Please submit DD214 or other proof of service.

33. Honoree Name
35. Hometown
37. Rank
39. Branch of Service
41. Dates of Service
43. Location State
44. Zip Code
46. Phone Number
47. Cellphone Number
49. Email Address
51. Notes/Other
55. Costs:

    1. $25 for new/initial request to have a name added to the Wall of Honor at the Veterans Tribute at CLP
    2. $50 to have any information added/edited to an existing name plate later
    3. Donations are accepted in any amount above and beyond these fees above &/or simply for the cause
57. Payment Options:

    1. Check made payable to the "City of Oviedo" (Attn: Veterans Tribute)
    2. Cash - can be accepted if paid in person at the Oviedo Gym and Aquatics Facility or Riverside Park, during normal operating hours
    3. Pay with Credi card **VISA or Mastercard ONLY**
61. Application Instructions

    Fill out this form completely  and submit the electronic form when completed. 

    You can also download and fill out this form and mail it with your payment to:

    
    

    Oviedo Recreation and Parks Department

    Attn: Veteran's Tribute - Wall of Honor

    City of Oviedo

    400 Alexandria Blvd.

    Oviedo FL 32765

    You can also drop this form off at:

    
    

    Oviedo Gym and Aquatics Center

    148 Oviedo Blvd.

    Oviedo FL 32765

    OR

    Riverside Park

    1600 Lockwood Blvd.

    Oviedo FL 32765

    For questions, call 407-971-5565 or 407-971-5575

63. Credit Card Payment
65. Name on Card
67. Card Number
68. Expiration Date

    Month/Year

70. Security Number

    3 Digit Number

71. Total Amount
73. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
75. Electronic Signature
Leave This Blank:


77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

* indicates a required field