Disaster Relief Fund Application
This application is for VFW Members only. Auxiliary members must use a separate form provided by the Auxiliary.
Applicant Information
*
First Name
Last Name
Post #:
*
Membership #:
*
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Where to send Disaster Funds if application is approved? Relocated Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Disaster Information:
Please check the type of disaster & list the damages incurred:
*
Fire
Flood
Hurricane
Tornado
List of damages:
*
Will Home Owners Insurance or any other type of insurance cover the lost?
*
Yes
No
Have you applied for FEMA assistance?
*
Yes
No
Amount received from FEMA:
Please submit any photos you have for proof of damages:
*
Browse Files
Cancel
of
Please choose how you would like to receive your Disaster Relief:
*
Check (Mailed to the address listed above)
ACH Payment/Direct Deposit (If you choose this option, please fill out the information below for processing)
FINANCIAL INSTITUTION INFORMATION:
ROUTING NUMBER:
ACCOUNT NUMBER:
Please sign and date the application to verify that the information you have submitted herein is true to the best of your knowledge, and that you understand that funds are limited and the demand is great. Funds will be apportioned on an “As Needed” basis.
*
Signature
Clear
Submit
FOR DISASTER RELIEF COMMITTEE ONLY:
Should be Empty: