Hometown Heroes Banner Program | Dyersburg State Gazette

Date of Submission:

Deadline to submit your application: April 19, 2024:

Please review the Hometown Hero Banner Program Guidelines for further details. Hometown Hero banners are $300 per banner.

I have read, understand, and will follow the guidelines.

By clicking the box above, you are electronically signing and agree that this is as binding as your actual signature.

Veteran Information

Full name: (As it will appear on banner):

Military Rank:

Branch of Military:

Era of Service:

Peacetime: (Please give dates of service):

Leave this field blank if you did not choose "Peacetime."

Is Veteran Alive, Deceased, KIA, POW/MIA:

Veteran must grant permission to be honored on a banner if currently living.

Alive
Deceased
KIA
POW/MIA

Have the veteran click this box if they are living.

By clicking the box above, you (the veteran) is electronically signing this permission request and agree that this is as binding as your actual signature.

Your Information

Contact name:

Relationship to Veteran:

Phone:

Email:

Address:

Photo Release

I hereby grant State Gazette permission to use the attached photo, which includes a likeness of myself or of my relative, in the State Gazette Banner Program. State Gazette may use images of the banner in promotional materials without notification or additional permission. I take full responsibility that all information provided about the Veteran being honored is accurate and correct. *Must be signed by Veteran if living. By clicking the box above, you and/or the veteran is electronically signing this permission request and agree that this is as binding as your actual signature.

Photo upload:

Payment:

Please make checks payable to State Gazette and reference “Hometown Heroes” on the check.

Mail payment to State Gazette Hometown Heroes, P.O. Box 808, Dyersburg, TN 38025, or drop off payment with the application at the State Gazette office located on the North side of Veterans’ Square at 114 West Court St, downtown Dyersburg, TN. Online payments are available.

Online payment link:

Please copy and paste into the URL field on a separate browser window or simply click on the link:

https://checkout.square.site/merchant/MLQN6KQ16MRNV/checkout/TQ6DLJWQ2DIJ7SMUI44...