"Thank You For Your Service" Veteran Form
"Thank You For Your Service" is a program produced by ChicopeeTV that features voices of men and women who have served in the armed forces.  Veterans who are interested in appearing on the show to share their experiences should complete the below form.  Thanks for your interest in the show, and for your service to our nation's armed forces!

Note: Due to a limited number of slots on the program, completing the form does not guarantee inclusion in the show.  Many factors come into play, such as availability and period of service (we are looking for a diversity of experiences from all different eras).  We will be in contact if/when we have a slot available for your voice.
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First Name *
Last Name *
Phone *
Email
Branch of service *
Check all that apply.
Required
Component *
Check all that apply.
Required
What was your highest rank achieved? *
Did you retire from the military? *
What type of segment(s) would you allow us to shoot? *
Check all that apply.
Required
Did you ever deploy?  If so, where? *
Check all that apply.
Required
When did your service begin? *
MM
/
DD
/
YYYY
When did your service end? *
MM
/
DD
/
YYYY
How are you connected to Chicopee? *
Check all that apply.
Required
Do you have transportation or mobility concerns? *
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