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2. Hometown Heroes Recommendation
   Do you know a Middletown resident in actively serving the armed forces? Send us photo and a short biography so we can add him or her to our tribute wall at Town Hall.
4. Soldier Information
6. Soldier's First Name*
7. Soldier's Last Name*
9. Branch of Service*
   -- Select One --Air ForceArmyCoast GuardMarine CorpsNavy
10. Current Deployment
12. Local Schools Attended
13. Photo*
    Send your favorite photo of your hometown hero. Photo size is 4x6 portrait. (You can send a another size but we may need to crop it)
15. Addtional Information
17. Expected Date of Discharge*
    (Month/Year)
19. Contact Information
    Please provide your contact information in case we have any questions about your submission. Thanks!
21. First Name*
22. Last Name*
24. Street Address*
26. Town*
27. State*
28. Zip Code*
30. Phone Number*
31. E-mail*
33. Need Help?
    Submissions can also be mailed or dropped off at the Mayor’s Office. The address is Middletown Town Hall, 1 Kings Highway, Middletown, NJ 07748. Call 732-615-2287 for more information.
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35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field