Application for wall of service

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Electronic Application for a Plaque on ‘Fleet Air Arm Wall of Service’

Please make sure you have read the General Information page regarding the Wall of Service. This contains detailed information you need to know before applying for a plaque. To return to the General Information page click here.

If you are happy with the General Information, please complete the form below and then click on the ‘Submit’ button. Fields marked * are mandatory. Be very careful to fill out the details correctly as they cannot be changed once the plaque is ordered.

Once you have submitted the form you will be contacted within a day or two with payment details. Your application for the plaque will then be processed when your payment has been received.

Application for FAA Wall of Service Plaque (Revised)

Certification
Applicant Certification*
- I am the person whose name will appear on the plaque
- I am applying on behalf of a deceased member
Approval of Next of Kin*
- I understand I will need written approval from the deceased applicant's Next of Kin.
Details of Person Making This Application
Name of person making this application
First Last
Address of person making this application*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Mobile Phone of person making this application*
Home Phone of person making this application
Primary Email of person making this application*
Are you a Member of the Fleet Air Arm Association of Australia?*
- Yes
- No
Details to go on the Plaque
Initial(s) and Surname to go on the Plaque*
Initial(s) Surname
Highest Achieved Rank/Rate.*
Specialisation/Branch?*
Official Number*
Date of Entry into RAN Service (DD/MM/YYYY)*
Date of Discharge from RAN (DD/MM/YYYY). Insert 'Still Serving if you are).*
Insert year/month of qualifying postings to Squadrons/Air Dept*
Do you have any particular requests in regard to placement of your plaque, or any other consideration? (Note that we cannot necessarily comply but will do our best)
Advise how you would like to be notified once your Plaque is affixed to the Wall
- via Slipstream Magazine (Default)
- via Email
Declaration
You must certify that the above details are correct and hereby submit your application for consideration of the Executive Committee.*
- I certify that the details are correct.
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Fleet Air Arm Association of Australia

Application for wall of service

Electronic Application for a Plaque on ‘Fleet Air Arm Wall of Service’

Application for FAA Wall of Service Plaque (Revised)

Certification

Details of Person Making This Application

Details to go on the Plaque

Declaration