Military Moment Enrollment

Christian FM and Sea Coast Air Conditioning have teamed up to honor those who have served this nation and allow us to enjoy the freedom that we have. It's easy to nominate a veteran, or someone who is still serving. Simply complete the form in its entirety and we will create a spot that will air to honor them. You may also request the spot to be emailed to you. Thank you for helping us honor those who serve!

Enrollment Form:

Veterans Name(Required)

First Last

What branch of the military did/do they serve?(Required)

What was/is their rank?(Required)

Did they see combat? If so in what conflict?(Required)

What years did they serve?(Required)

Did they receive any special honors? If so please list.

If they are still alive where do they live? Can you tell us a little bit about them. If they passed away please provide that year.(Required)

What is your email address?(Required)

Would you like us to send you an mp3 of the spot once it is ready?(Required)

Yes

No thank you

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Military Moment Enrollment

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