Military Service Recognition Book Volume XVI 32 Branch Joined Command & Branch # Location Date Joined Date Left Office Held Honours and Awards Held Command & Branch # Office Date Command & Branch # Award Date TO BE COMPLETED BY THE LEGION BRANCH Command: ______________________ Branch Name: _______________________________ Branch #: _______________ Branch Address: ___________________________________________________________________________________ Service Information Person who served: Self or (Name): _______________________________ Relationship: __________________ who is/was an Ordinary Member of Command/Branch: ______________________________ Membership #: _______________________ Service # _________________________________________________________________________________________ Documentation Service Record Discharge Certificate Marriage Certificate Birth Certificate Adoption Certificate Other: _________________________________________________________________________________________ Discharge Date: _________________________________ Type of Discharge: _____________________________________ Theatres of Service: _______________________________ Medals/Decorations: __________________________________ _______________________________ __________________________________ _______________________________ __________________________________ Next of Kin Name: _____________________________________ Relationship: ___________________ Tel: ______________________ Administration Certified that section 221 of the General By-Laws has been applied and that satisfactory proof of service and relationship has been submitted where applicable. Branch Membership Committee: _______________________________________________ Date: _____________________ Date Passed at General Meeting: ______________________________________ Date of Initiation: _____________________ Membership Dues Paid: ___________________________________________________ Date: _____________________ Membership Registration Form and Per Capita Tax Submitted to Dominion Command Date: _____________________ Record of Legion Service Date of Original Admission to Legion: ________________ Membership #: ______________ Date of Initiation: ______________ legion.ca Nov 2023 800293
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