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Combat Veteran BIO

Date of Birth, Spouse's name and DoB if applicable, Home Town, Current Address

Branch of Service, rank and amount of service time

Bio including brief service history prior to related injury

Description of Injury Event including date and location

Description of Injury

Any prior motorcycle riding experience and future plans and how receiving this gift may affect you and your family

Helmet Size

Vest Size

Please upload a copy of your DD-214
Please upload photos before and after injuries.

Thanks for submitting!

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