By submitting information on this form, you are agreeing, without compensation, to be included as a U.S. military veteran on Coconut Creek's Virtual Veteran's Wall. The soldier's name, military branch, and likeness shall be displayed on this webpage, and may be published on social media posts, City publications, street banners, and/or Veteran's Park banners. All veterans displayed on the Virtual Wall must reside or have resided in the City of Coconut Creek.

Veteran's Recognition Registration

If family member or friend submitting on behalf of a veteran, please include the following information:

Please click on checkbox if you have consent from the veteran to submit their information on their behalf.

Please check the U.S. military branch(es) served:

Photo: Please submit a photo of your time in the military.

Please submit a photo of your time in the U.S. military.

Please email photo of veteran to: