Dvs Form 12 - High School Diploma Application For New Mexico Veterans Of World War Ii And Korea
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1HIGH SCHOOL DIPLOMA APPLICATION FOR NEW MEXICO VETERANS OF WORLD WAR II
AND KOREA
Qualifying Dates of Active Service
December 7, 1941 - December 31, 1946
(World War II)
June 27, 1950 – January 31, 1955 (Korea)
Veteran must have been scheduled to graduate after 1940 and before 1955
This form will be used by the New Mexico Department of Veterans Services to establish eligibility for any Honorably Discharged
Veteran who left a New Mexico high school prior to graduation to enter United States military service.
VETERAN'S INFORMATION: (Type or Print Clearly)
FIRST
MIDDLE (or initial)
LAST
MAILING ADDRESS (Number, Street and Apt #.)
City
State
Zip
e-mail address:
HOME PHONE (include area code)
DATE OF BIRTH
SOCIAL SECURITY NUMBER
VETERAN'S MILITARY SERVICE INFORMATION:
BRANCH OF SERVICES (Copy of Discharge/DD214 must be attached)
DATE(S) ENTERED
DATE(S) SEPARATED
_____/_____/_____
_____/_____/_____
_____________________________________________
Month Day Year
Month Day Year
Signature of Applicant ____________________________________________________ Date____________________________________
DIPLOMA INFORMATION:
HIGH SCHOOL OF ATTENDANCE AS IT SHOULD APPEAR ON DIPLOMA - (Please provide city/town/county)
DATE VETERAN WOULD HAVE GRADUATED:
Certification of Authorized Official(to be utilized by Department of Veterans Services Official)
____________________________________________________ Date ___________________________________
**************************************************************************************
** If other than the veteran, please provide the following information **
(Diplomas may be issued posthumously)
Name _____________________________________________________ Relation to Veteran ___________________________
Address ___________________________________________________ City ________________________________________
State ______________________________________ Zip ____________ Telephone ___(______)________________________
Please return application form and a copy of veteran's discharge/DD214 papers to:
New Mexico Department of Veterans Services
PO BOX 2324
Santa Fe, NM 87504
Attn: State Benefits
DVS Form 12 (July 1, 2015) (Previous editions are obsolete and will not be used)
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