Veterans Day Video Information Form

• Address:*
• City:*
• State:*
• Zip Code:*
• Email:
• Branch of Service:
  • Branch of Service:*
  • Rank:*
  • Significant Service Date:*
  • Where did you serve:*
  • Employment:*
  • Hometown:*

• Please submit a picture of yourself (or unit/squadron/platoon) in uniform in one of the following image formats, JPEG(jpg) or GIF (gif).– 15MB.
  Click “browse” to upload your photo from your PC.

If your picture is not in digital format please mail your picture to:

Circuit Court Admin Office, 14735 Main Street, M2407, Upper Marlboro, MD 20772

*Note: If you would like your picture returned please provide a Self Addressed Stamped Envelope

RSVP - May 16th

Example:

Veteran's Name:

• Name:    C. Philip Nichols, Jr.

Branch of Service:

• Branch of Service:    Navy
• Rank:    Captain, JAGC, USNR (Ret)
• Significant Service Date:    2002
• Where did you serve:    Guantanamo Bay, Cuba
• Employment:    Circuit Judge
• Hometown:    Laurel

Image: