Iraq Veterans Against the War P.O. Box 8296 Philadelphia, PA 19101 (215) 241-7123, ivaw@ivaw.org Would you like to present this information anonymously? Yes/No? Name:_________________________________ Address:__________________________________________ Phone:______________________ Email:________________________________ Date of Birth:____________ Occupation:______________________ Military Training:__________________________________________ Unit(s):_______________________________ MOS (including title):________________________________ Duty Period(s):__________________________Decorations:________________________________________ Numbers of Tours (if any): ____Iraq ____Afghanistan ____ Other; please specify______________ .AO:___________. DD214 (Check one): ____in IVAW records ____Attached ___Will Provide (No veterans or military personnel will be able to testify without a DD214 or military ID). Do you have any documentation, to include photos, videos, military orders , SOPs, memos or any relevant documentation?____________________________________________________________ Are there people whom IVAW can contact to corroborate your accounts? If so please list names and contact information:______________________________________________________________________________ ________________________________________________________________________________________ Please include information that indicates the dates and locations presented in this material as well as the units and commanders involved if they are O-4/E-8 or above. If you are sending a large amount of material please provide instructions on what you feel is most important Is there anything else you would like us to know or that you think is important? Do you have friends that can provide similar evidence? If so, please help us get in contact with them. Is any evidence provided classified?
Iraq Veterans Against the War
P.O. Box 8296
Philadelphia, PA 19101
(215) 241-7123, ivaw@ivaw.org
Would you like to present this information anonymously? Yes/No?
Name:_________________________________ Address:__________________________________________
Phone:______________________ Email:________________________________ Date of Birth:____________
Occupation:______________________ Military Training:__________________________________________
Unit(s):_______________________________ MOS (including title):________________________________
Duty Period(s):__________________________Decorations:________________________________________
Numbers of Tours (if any): ____Iraq ____Afghanistan ____ Other; please specify______________
.AO:___________. DD214 (Check one): ____in IVAW records ____Attached ___Will Provide (No veterans or
military personnel will be able to testify without a DD214 or military ID).
Do you have any documentation, to include photos, videos, military orders , SOPs, memos or any relevant
documentation?____________________________________________________________
Are there people whom IVAW can contact to corroborate your accounts? If so please list names and contact
information:______________________________________________________________________________
________________________________________________________________________________________
Please include information that indicates the dates and locations presented in this material as well as the units
and commanders involved if they are O-4/E-8 or above.
If you are sending a large amount of material please provide instructions on what you feel is most important
Is there anything else you would like us to know or that you think is important?
Do you have friends that can provide similar evidence? If so, please help us get in contact with them.
Is any evidence provided classified?
Can we fill this out as Cpl. Jesse McBeth and send them in in mass?