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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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