Veterans Memorial Application
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Applicant's Name:
(Name of Person to be Memorialized)_____________________________________

Time of Service in Armed Forces: ____________________to_______________________

Branch of Armed Service:____________________ Rank:___________________

Has the applicant been memorialized at any other Veterans memorial?     Y      N     If YES, please specify.

Name of Person Making Application:____________________________________

Address: ___________________________

City: ______________________________ State:________ Zip:________

Phone:__________________________

1. Has the applicant served in any branch of the Armed Forces?     Y      N
If NO, the applicant is ineligible to be memorialized at this monument.

2. a. Was the applicant born in Knox County?      Y      N

b. Was the applicant brought up in Knox County?      Y      N

c. Has the applicant resided in Knox County?      Y      N
Please list dates of residency. ______________________________

d. Is the applicant buried in Knox County?     Y      N

You must answer YES to at least one of the questions stipulated in #2 in order to be eligible to be memorialized at this monument.

3. Did applicant receive an Honorable Discharge from the service?      Y      N
If NO, the applicant is ineligible to be memorialized at this monument.

Appeals Procedure:
If the applicant is denied, you may appeal the decision. The appeals process is as follows.

A. Make a written request to the Knox County Veterans Memorial Committee to address them in the next regular meeting. All correspondence must be sent to: Knox County Historical Commission, attn: Veterans Memorial Committee, P.O. Box 77, Benjamin, TX 79505
B. Enclose a brief outline explaining the extenuating circumstances regarding the applicant and the committee's reason for denial.
C. Address the Knox County Veterans Memorial Committee at the next regularly scheduled meeting.
D. A written response to the appeal will be mailed within 72 hours of the appeals meeting.

If you have any information regarding a veteran who may qualify for the Knox County Monument, please contact the Knox County Historical Commission's office at 940/454-2229 or e-mail at kchc@nts-online.

Knox County Historical Commission
Attn: Veteran's Memorial Fund
P.O. Box 104
Benjamin, TX 79505-0104
(940) 454-2229

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