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Salute To Veterans Nomination Form

Nominee (Veteran) Full Name(Required)

First Last

City / Town of Residence(Required)

City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

Branch of Service(Required)

Select branchArmyNavyAir ForceMarinesCoast GuardSpace Force

Years / Period of Service(Required)

Rank / Title (optional)

Unit / Deployment Location(s) (optional)

How do you know this Veteran? (optional)

Tell Us Their Story(Required)

Please share details that help us understand their service and impact.

Photo of the Nominee (optional)

Accepted file types: jpg, jpeg, png, heic, Max. file size: 10 MB.

Nominator Full Name(Required)

First Last

Nominator Phone Number(Required)

Email(Required)

Nominee Permission(Required)

I confirm I have the nominee’s permission to share this information.

Official Rules Agreement(Required)

I agree to the official contest rules.

KCHA, North Iowa Broadcasting, Inc., and Coloff Media, LLC conducts contests and giveaways for our listeners.

1.  Winners must be 18 years of age or older. Employees of KCHA and their immediate family members (including spouses and children) are not eligible to play.


2. Persons may only win once for the duration of contest(s), or once every 30 days for ongoing giveaway(s).


3. Prize(s) must be claimed within 30 days, and can be done so in person at the KCHA Studio, located at 207 N. Main St, Charles City, IA 50616 during regular business hours.


4. Failure to claim prize(s) constitutes forfeiture, and becomes property of KCHA.


5. Difficulties with phone line(s) or the winner's inability to claim prize(s) is not the responsibility of KCHA.


6. Once claimed, prize(s) become the property of the winner. KCHA takes no control or responsibility of the use of prize(s) after it is awarded.


7. No substitutions for an unwanted prize(s) will be available by KCHA or the providing business, and prize(s) may not be traded nor combined with other prize(s).


8. Winner will not hold KCHA responsible for any taxes, injury or expenses incurred while utilizing prize(s).


9. No purchase is necessary to enter any contest. Void where prohibited.


10. Prizes won from KCHA are not to be sold.  Winner(s) who are found to sell a prize won on our station will be disqualified from future prize winnings.


11. As a winner, you acknowledge that KCHA has the right to, without prior or further authorization, publicize your name, character likeness, photograph, voice recordings, and broadcast the fact that you are a winner for promotional purposes without financial remuneration.


12. KCHA reserves the right to end contest(s) or giveaway(s) at any time without additional notice.


13. KCHA reserves the right to make any rule or contest changes at any time without additional notice.


14. The decision of KCHA in the interpretation of the rules is final.


15. By participating in contest(s) and giveaway(s), persons agree to the all of the above and are bound by the decisions of KCHA.

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