Welcome to California

Roster E-Mail Form

Resources for the Veterans Community

California Women Veterans Roster - Roster Application Form


Preferred Salutation
(Mrs./Miss/Ms./Dr./Rev., etc.)
First Name:
Middle Name or Initial
Last Name:
Addition (RN, PhD, etc.):
Service Last Name (if different from above):
Street Address:
Care Of or Additional Address:
City:
State:
ZIP Code
Work Phone:
Fax Phone:
Home Phone
E-Mail Address:
Occupation:
Current Employer:
Currently on Active Duty (Y/N)?:
Branch of Service:
Rank or Rating:
Service Dates - From:
Service Dates - To:
Veterans Organizations (enter up to six):

California Veterans Memorial

You may also want to register for the California Veterans Memorial. A basic entry will contain your name, occupation, branch of service, rank, and service dates. For a donation of $50, you may also enhance your registry entry with a photograph and short statement or bio.