ATTENTION:  Deadline for Veteran name submissions has been EXTENDED to December 16, 2019!
Submission by this day guarantees name placement for the dedication on Memorial Day, Monday – May 25, 2020!

Veteran Registration

The Veteran Honor Walls surrounding the fountain memorial is for any and all Veterans, including those who may be currently in active duty.  The engraving will be in granite stone, and will be present on the honor wall indefinitely.

It is highly encouraged to share further information, including the Veteran’s bio and photo to be added to this website, and for archive purposes.

The cost for registering a Veteran is $250 and can be paid via credit card through this website, or a check can be mailed to:

Clarence Rotary Veterans Memorial
PO Box 159
Clarence, NY 14031

To download a PDF of the Veteran Registration, please CLICK HERE.

If you already submitted a form, but still need to upload a bio and photo, please CLICK HERE.









Veteran Information:











WWIWWIIKorean WarVietnamGolf WarPanamaSomaliaGrenadaDesert StormGlobal War on TerrorIraqAfghanistanPeacetime





ActiveReserveHonorably DischargedRetiredKilled in ActionKilled in ServicePOWMIA



ResidentFamily Member of ResidentBusiness OrganizationService OrganizationOther










I warrant that the information submitted to the Clarence Veterans Memorial is accurate and complete in all respects. I acknowledge that the information provided will "literally" be carved in stone, and that any changes after the original engraving will be the responsibility financially of the sponsor. This includes any factual errors discovered by outside parties. I acknowledge that the Clarence Rotary Foundation and the Clarence Veterans Memorial will not be responsible both physically and financially for any errors of information submitted through this form.

I have reviewed the information contained herein, and represent that it is factually true, accurate and complete. I understand that the Clarence Rotary Foundation and the Clarence Veterans Memorial may use the information I provided for public records, advertising opportunities, and promotional opportunities. The above terms and conditions will become effective and be binding upon and enforceable upon submission of the information.

By checking this box, I agree to submit this application electronically and understand that an electronic signature has the same legal status and can be enforced in the same way as a written signature.




***NOTE – SUBMISSION OF THIS FORM COULD TAKE UP TO A MINUTE TO LOAD.  IF YOU ARE STILL HAVING DIFFICULTIES PLEASE CONTACT US***