Family & Friend Veteran Roof Giveaway Submission
NOTE: In order to be eligible for this giveaway Veteran must live within a 60 mile location of our main office in Fredonia PA
Your Name
First Name
Last Name
Your Email
example@example.com
Your Phone Number
Please enter a valid phone number.
Relationship to Veteran
Veterans Name
First Name
Last Name
Veterans Phone Number
Please enter a valid phone number.
Veterans Email
example@example.com
Veterans Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Are they an active military member?
Please Select
Yes
No
What Military Branch did they serve in?
How do you know this veteran?
Reason for Nomination
How long did they own this house?
Do you know what type of roof they have currently?
Do you know how old there current roof is?
Please provide one of the following if possible:
Browse Files
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Choose a file
-DD214-Driver's License if the state provides a veteran's stamp-VA Card-Active Military ID Card*Submit Video Here For Family Member Submission
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