A Keshequa Middle School Social Studies Activity
Keshequa Central School, Nunda NY

Our Project Team is collecting information on individuals who have served in the United States Armed Forces at anytime in the past. We are interested in all veterans, especially those who live or have lived in the general Nunda area. The information will be entered into our project data base. Veterans who live or have lived in the Nunda area will also be included in our electronic database. This database will be available to area students, researchers, and genealogists through a cd-rom and the internet.

We hope you will participate in our Project by filling our the form below. If you have any questions, comments, or concerns, please contact the Project Team at 468-2541 ext 2065

Directions: This form can be filled out by the Veteran, a family member, or a descendant of a Veteran. The items marked with a * are required, the others are optional. All forms will be entered in the database, but only those with signed permission by the Veteran or family member will be entered into the electronic database. Addition directions can be found here.


*1.Veteran's Name _______________________________________________________


2. Birth information

a. Date of Birth _______________________________________

b. Place of Birth ______________________________________

3. Death information (if applicable)

a. Date of Death ______________________________________

b. Place of Death______________________________________

c. Place of Burial______________________________________


*4. Residence (see specific directions)



*5. Military Experience (see specific directions)

a. branch of service ______________________________________

b. years of service _______________________________________

c. experiences



6. Additional Information



7. Are there primary or secondary records or materials related to this veteran that we could make copies of to include in our database?

Yes No

If yes, please describe






*8. Person filling out the form ______________________________________________________________________________________________


9. Permission to include the information in the electronic database:


Signature of Person Giving Permission Date Relationship to Veteran


*10. Contact Information



You can send the completed form to Tom Cook, PO Box 177, Nunda NY or email to