4th Congressional District Veteran of the Year

Criteria: Your nomination package must be for a Veteran who has been honorably discharged from any branch of the United States Armed Services and a current resident of 4th Congressional District of Virginia. Three finalists will be asked to submit a DD214 with a redacted social security number, subject to verification by the congressional office, and two photos (one in uniform and one current).

indicates information that you need to provide.

Your Information

Prefix:

First Name:

MI:

Last Name:

Suffix:

Physical Address:

Physical Address Continued:

Mailing Address:

Mailing Address Continued:

City:

Email:

Telephone

Phone Number / Type:

What are these options?
Constituents who are hard of hearing or use a video phone have the option to choose TDD or VP based on the type of device they are using. This allows our office to respond to them accordingly. The default option "Voice" is a standard audible telephone.

Service

Branch of Service

Periods of Service

Rank/rate

Significant Conflicts

Nomination Questions

Provide a written description of contributions in support of your community since your military service:

Describe your service to other veterans (membership in veteran organizations, outreach, leadership roles):

Describe your participation in nonprofit groups (USO, Salvation Army, United Way Worldwide, and church organizations):

Write a short paragraph about yourself telling us who you are:

Date and Signature

Today's Date:

Signature:

4th Congressional District Veteran of the Year

Office Locations

Washington, DC Office

Central Virginia Office

Hampton Roads Office