The Legacy Foundation of Southeast Arizona and Canyon Vista Medical Center are seeking nominations of former or current Cochise County residents who served honorably in the U.S. armed forces and contributed to their community. Nominations can be mailed by August 25, 2017 or submitted electronically through the Legacy Foundation website. Nominations must include proof of military service, a 1000-word summary of the nominee's service history, and a 1000-word summary of their community contributions. Honorees will be recognized with a plaque on the Veterans Wall at Canyon Vista Medical Center from November 11, 2017 to November 11, 2018.

1. Nomination Form and Instructions
NOMINATING CRITERIA
The Legacy Foundation of Southeast Arizona and Canyon Vista Medical Center and seek to recognize those former or
current residents of Cochise County who have worn the uniform of the nation’s armed forces and have contributed to
their community. The nominee must have honorably served as verified by a U.S. military service document such as a
DD214, Certificate of Release or Discharge from Active Duty, or DD Form 363, Certificate of Retirement.
Mailed nominations are to be sent to Veterans Wall, Legacy Foundation, PO Box 1089, Sierra Vista, AZ 85636 and
must be postmarked by August 25, 2017.
Electronic nominations should be completed on the electronic nomination form found on the Legacy Foundation
website: www.lfsaz.org. The nomination must be dated no later than August 25, 2017.
Nominations may be submitted posthumously.
Individuals selected will be honored with an individual plaque on the Veterans Wall at Canyon Vista Medical Center
from November 11, 2017 to November 11, 2018.

2. Veterans wall nomination form
Canyon Vista Medical Center Legacy Foundation of Southeast Arizona
Name of Veteran Nominee __________________________________________________
Veteran Nominee’s Home Address ____________________________________________
Veteran Nominee’s Home Phone Number ______________________________________
Veteran Nominee’s Email ___________________________________________________
***
Nominator’s Name _________________________________________________________
Nominator’s Address________________________________________________________
Nominator’s Email __________________________________________________________
Signature of Nominator___________________________Date_______________________
Checklist:
Proof of Military Service
Summary of Military Service, 1000 word maximum
Summary of Community Contributions, Honors, and Awards, 1000 word maximum
Mailed nominations are to be sent to Veterans Wall, Legacy Foundation, PO Box 1089, Sierra Vista, AZ
85636 and must be postmarked by August 25, 2017
Electronic nominations should be submitted by August 25, 2017at www.lfsaz.org

3. SUMMARY OF nominee’s MILITARY SERVICE (1000
WORDS)
To Include: Date and place of entry into active duty Date and place of retirement or
release from active dutyHighest rank held Military job specialty Duty
assignments Military education Awards and decorations Total years of service

4. SUMMARY OF community contributions,
Honors, and Awards (1000 WORDS)
To Include: Contributions that helped make the nominee’s community a better place to live
and work; areas such as public education, safety, transportation infrastructure, volunteerism,
professional organizations, cultural activities, health/wellness programs , youth welfare, and
similar activities should be included. Community recognition of the nominee should also be
mentioned.