---

There is a unique number on the back of each American Hero Band. Please use that number to register your Hero Band once you have received it.

Hero Band number:  (i.e. 001987)
(*you can find the number on the back of your band)

---

Email:
First Name:
Last Name:
State: --- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Year of Birth:  
Sex: Please Select Male Female
How did you find out about the Hero Band? GX Magazine Army Guard Mail Magazine TV Commercial Radio Commercial Outdoor Ad (billboard, side of vehicle etc...) Promotional Item Friend E-Mail School Staff In School TV Internet/Website Parent or other Adult Person in Service Newspaper Movie Ad NASCAR 1-800-GoGuard Website
How do you know the person who gave you the Hero Band? Please Select Original Owner Son/Daughter Husband/Wife Employee Friend Co-worker Special Event
Who are you honoring? Please Select Any Soldier Specific Soldier Unit
Full name of specific soldier you are honoring
What state are they from? --- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
What unit are they in?
Where are they deployed?

---

---