The Long Beach Hometown Heroes Project Return form to: Office of Councilwoman Gerrie Schipske 333 W.

Ocean Blvd. Long Beach, CA 90802 (562) 570-6932 or send via email to: district5@longbeach.gov

The City of Long Beach in conjunction with The Long Beach Rosie the Riveter Foundation wishes to show our pride and respect for the brave men and women who are serving in all branches of the military. The Long Beach Hometown Heroes Project consists of banners displayed along Clark Avenue between Carson Avenue and Spring Street and in the Long Beach Rosie the Riveter Park and Interpretive Center. A short biography and photograph will also be included on our website: www.lbhometownheroes.com. The cost for each banner is $270 and individuals, organizations and businesses may sponsor banners. Additionally, a permanent plaque can be placed on the Memorial Wall at the Long Beach Rosie the Riveter Park for an additional $100. Banners will hang up to 12 months and then be given to the families of the service member. If you know of a Long Beach resident or alumnus of a Long Beach high school that is currently serving, please share this form with their family, so they can be represented with a banner on Clark Avenue. Correct spelling of name for banner:

First Name

M.I. (optional)

Last Name

Rank or Title Army Navy Air Force

Age Marines

High School Coast Guard

Please include a short biography, if desired:

Name and address of parent or other contact person residing in Long Beach.

First Name

M.I. (optional)

Last Name

Address

City

State

Zip

Phone

Email

Signature (person granting permission to use name)

I have included an unframed photo, 5x7, to be included on the website. (We will make color copies of your photos and return the originals to you within a few days.) Please include any organization, business or family that would like to be the financial sponsor for the banner with contact information. Checks for the banner ($270) should be made payable to: The Long Beach Rosie the Riveter Foundation (a nonprofit, 501 3(c)). You can go online to: www.lbrosie.com and download the form to order a permanent plaque. Date submitted: Date & received by: