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Nominate a 4 State Hero

  1. Hero must be either a Veteran (living or deceased) or currently serving.
  2. Hero must have served, or is serving, during wartime.
  3. Must provide a photograph of Hero in military uniform.  Photos submitted in person or by mail will be returned to you.
  4. Hero must have been born in, or lived in, the KOAM/KFJX viewing area.
  5. KOAM/KJFX retain editorial control and reserve the right to edit content.
  6. KOAM/KFJX will make every effort to include those Heroes who meet the above criteria.
  7. You will be notified via mail when your Hero is scheduled to be honored on KOAM/KJFX.
  8. If you prefer to submit your application in writing, use our printable PDF application.
* Your Name
Your Relationship to Hero
** Your daytime phone #
Your mailing address

** Email Address
** Confirm Email
* Hero's First Name
Middle Name
* Last Name
Nick Name
* Hero's Branch of Service

* Rank
* Hometown
* Wartime Service Dates
Wartime Location(s)
Major Battle(s)
* Military Service Dates
Unit
Significant Accomplishments
Medals
Remarks
File Size Max 100KB Per Photo
*** Photo1
*** Photo2
*** Photo 3
   

Large files and/or slow connection speeds may result in longer upload times.
   
Upload may take several minutes, please wait for the 'Thank You' page.
* - Required field
** - Either Phone OR both Email addresses are required
*** - Either choose a photo or select "I will provide a photo some other way"