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Rich Township High School District 227 6:300-E1

Instruction
DRAFT
Exhibit - Application for a Diploma for a Service Member Killed in Action or for
Veterans of WWII, the Korean Conflict, or the Vietnam Conflict
Complete and submit to the Superintendent.

Please print:

Name to Appear on Diploma Phone

Address Birth Date

City State Zip
For Veterans of WWII, the Korean Conflict, or the Vietnam Conflict

The applicant is requesting a high school diploma and attests that he or she meets the following
criteria as established by Board of Education policy:

1. Served in the U.S. Armed Forces during World War II, the Korean Conflict, or the Vietnam
Conflict.

Please check one or more of the following:
World War II: December 7, 1941 - December 31, 1946, including the induction
period of September 16, 1940 – December 6, 1941
Korean Conflict: June 27, 1950 - January 31, 1955, including the induction period of
January 1, 1947 – June 26, 1950
Vietnam Conflict: January 1, 1961 – May 7, 1975
2. Left high school in order to serve in the U.S. Armed Forces.

3. Resided within an area currently within the School District at the time he or she withdrew
from high school.

4. Has not received a high school diploma or a GED (high school equivalency).

Applicant’s Name (printed) Signature Date

For Service Members Killed in Action

The applicant is requesting a high school diploma on behalf of a service member who was killed in
action and attests that the deceased service member meets each of the following criteria as established
by Board policy:
1. Was killed in action while performing active military duty with the U.S. Armed Forces.
2. Left high school in order to serve in the U.S. Armed Forces.

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