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Rainbow Division Memorial Foundation, Inc.
Family Members Information

Print this form and Mail To: Barbara Eberhart, 750 Vanderbilt RD, Ellensburg, WA 98926

VETERAN: NAME (LAST)___________________________(FIRST & INITIAL)_____________________

WW (1 or 2)_____ 42nd ID_____Unit/Co/Reg't/Battery/etc.___________________
Date of Death___________(If Deceased)

Relation to Veteran ____________________________________________________________________
(Wife, Widow, Son , Daughter, Gr-son, Gr-Daughter, Sister Brother, Niece, Nephew, other)

Last Name, First, Initial___________________________________________________________________

Address:_____________________________________________________________________________

City___________________________________________________State_________Zip______________

Phone No.:________________________e-mail:______________________

Relation's Birthday and Mother's name ______________________________________

Veteran's Spouse_______________________________________________________________________
Is relation a member of Rainbow?_______ If "YES" name of Chapter _________________________,
Life Member ?___________
Document/Memorabilia designated for Rainbow Archives (if any) available now___ later___ might consider__
Comments:____________________________________________________________________________

Name of person filling out this form___________________________________________Date___________
Address______________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Phone No.________________________e-mail:________________________
Please list additional family names, relation to the veteran and addresses on additional page

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