APPLICATION FOR DIPLOMA

WORLD WAR II or KOREAN or VIETNAM VETERANS

Name: ________________________________________________________________________

Current address: ________________________________________________________________

Name and address of high school attended: ___________________________________________

______________________________________________________________________________

Dates of attendance: _____________________________________________________________

Year veteran would have graduated: ________________________________________________

Date entered military service: ______________________________________________________

Branch of service: _______________________________________________________________

I verify that the above information is accurate.

_____________________________________        ______________________________

        Signature        Date

I am applying on behalf of _______________________________, who is deceased. I verify that the above information is accurate.

_____________________________________        ______________________________

        Signature        Date

_____________________________________

        Relationship to Veteran