National Memorial Arboretum AJEX Ceremony – 21st June 2023

Date

Wednesday, 21st June 2023

Time

1:00pm

Location

Alrewas
Staffordshire

Main applicant

First name: *

Surname: *

Address: *

Postcode: *

E-mail address (If you don't have an e-mail address please call the office): *

Telephone number: *

I am interested in the subsidised return coach journey to the NMA, leaving from a North London destination:

I am a member of AJEX (Non-members are welcome):

I am a Veteran:

I am currently serving:

I consent for you to contact me regarding AJEX's charitable work:

How did you hear about this AJEX event?: *

Other:

Please tick if you are Under 18:

Additional attendees

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}</script><input type="text" id="fb-Attendees-[ITEMINDEX0]-AttTownCity" name="fb-Attendees-[ITEMINDEX0]-AttTownCity" value="" class="form-control " size="20" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttPostcode-field-type" value="text" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttPostcode-field-required" value="1" /><div  id="fb-Attendees-[ITEMINDEX0]-AttPostcode-div" class="form-group field field_text "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttPostcode">Postcode: <span class="required">*</span></label></div><div class="input"><script>function fbvalue_8e4b9db72212141e4d2b80c544e618ee() { return document.getElementById('fb-Attendees-[ITEMINDEX0]-AttPostcode').value; }</script><input type="text" id="fb-Attendees-[ITEMINDEX0]-AttPostcode" name="fb-Attendees-[ITEMINDEX0]-AttPostcode" value="" class="form-control " size="20" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttEmail-field-type" value="text" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttEmail-field-required" value="1" /><div  id="fb-Attendees-[ITEMINDEX0]-AttEmail-div" class="form-group field field_text "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttEmail">E-mail address: <span class="required">*</span></label></div><div class="input"><script>function fbvalue_d1fdb33777a33447c360f6452713e0e3() { return document.getElementById('fb-Attendees-[ITEMINDEX0]-AttEmail').value; }</script><input type="text" id="fb-Attendees-[ITEMINDEX0]-AttEmail" name="fb-Attendees-[ITEMINDEX0]-AttEmail" value="" class="form-control " size="20" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttPhone-field-type" value="text" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttPhone-field-required" value="1" /><div  id="fb-Attendees-[ITEMINDEX0]-AttPhone-div" class="form-group field field_text "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttPhone">Contact telephone: <span class="required">*</span></label></div><div class="input"><script>function fbvalue_370b8df106b4fe699b31b2c97a7a019c() { return document.getElementById('fb-Attendees-[ITEMINDEX0]-AttPhone').value; }</script><input type="text" id="fb-Attendees-[ITEMINDEX0]-AttPhone" name="fb-Attendees-[ITEMINDEX0]-AttPhone" value="" class="form-control " size="20" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttExtInterest2-field-type" value="checkbox" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttExtInterest2-field-required" value="0" /><div  id="fb-Attendees-[ITEMINDEX0]-AttExtInterest2-div" class="form-group field field_checkbox "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttExtInterest2">I am interested in the subsidised return coach journey to the NMA, leaving from a North London destination:</label></div><div class="input"><input type="checkbox" id="fb-Attendees-[ITEMINDEX0]-AttExtInterest2" name="fb-Attendees-[ITEMINDEX0]-AttExtInterest2" onclick="" /><input type="hidden" name="fb-Attendees-[ITEMINDEX0]-AttExtInterest2-submitted" value="1" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttNotes-field-type" value="textarea" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttNotes-field-required" value="0" /><div  id="fb-Attendees-[ITEMINDEX0]-AttNotes-div" class="form-group field field_textarea "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttNotes">If you are a Veteran, we’d love to know any details of your Service – please detail this here:</label></div><div class="input"><textarea class="form-control " id="fb-Attendees-[ITEMINDEX0]-AttNotes" name="fb-Attendees-[ITEMINDEX0]-AttNotes" cols="40" rows="5" placeholder=""></textarea></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttExtOver18-field-type" value="checkbox" /><input type="hidden" id="fb-Attendees-[ITEMINDEX0]-AttExtOver18-field-required" value="0" /><div  id="fb-Attendees-[ITEMINDEX0]-AttExtOver18-div" class="form-group field field_checkbox "><div class="label"><label for="fb-Attendees-[ITEMINDEX0]-AttExtOver18">Please tick if you are Under 18:</label></div><div class="input"><input type="checkbox" id="fb-Attendees-[ITEMINDEX0]-AttExtOver18" name="fb-Attendees-[ITEMINDEX0]-AttExtOver18" onclick="" /><input type="hidden" name="fb-Attendees-[ITEMINDEX0]-AttExtOver18-submitted" value="1" /></div><div class="spacer"></div></div><input type="hidden" id="fb-Attendees-removed-[ITEMINDEX0]" name="fb-Attendees-removed-[ITEMINDEX0]" value="0" /><div class="removelink"><a class="btn btn-danger btn-xs" href="javascript: formbuilder_dynamic_remove_6037420d6fb0f031f13d0e615ec08400('[ITEMINDEX0]','')">Remove</a></div><div class="spacer"></div><script></script>

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AJEX – The Jewish Military Association is a UK Registered Charity – Reg. No 1129591. Registered in England and Wales. Company No. 06786615. Registered Office: Shield House, Harmony Way, London NW4 2BZ.

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National Memorial Arboretum AJEX Ceremony – 21st June 2023

Date

Time

Location

Proudly supporting those who serve:

Working closely with our associated organisations:

National Memorial Arboretum AJEX Ceremony – 21st June 2023

Date

Time

Location

Proudly supporting those who serve:

Working closely with our associated organisations:

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