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2. Please complete this recognition form so the citizens of Napa County may honor military personnel on active duty by displaying a personalized street banner in recognition of their service in the Armed Forces. 

   Deadline for submission is September 16 each year.

4. Name of Military Service Personnel*
6. Branch of Service*
8. Date of Enlistment
   Date of Enlistment
9. Anticipated Date of Separation from Service
   Anticipated Date of Separation from Service
11. Name and Address of Family Member or Contact Person:
13. Name (first and last)*
14. Relationship to Service Person
16. Address*
18. City*
19. State*
20. Zip Code*
22. Phone Number (with area code)*
23. Email Address*
25. Agreement

    By submitting this form you and your family member give permission to put your family member's name and Branch of the Armed Forces on a banner to be displayed in Veterans Park on Main Street in Napa.

27. 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.
29. Electronic Signature of Person Submitting Form*
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

* indicates a required field