Resourcing Needs Request
Name
First Name
Last Name
Email
example@example.com
Address
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Status
Active Duty
Veteran
NG or Reserve
Family Member or Friend
Are you a member of Vigilant Torch?
Yes
No
Years served in SMU:
Are you in need of resources?
Yes
No
What kind of resources? (Check all that apply)
Mental Health
Physical Health (medical issues, etc.)
Benefits
Financial Assistance
Scholarships
Information on Peer Mentorship Program
Networking
Employment
Information about Vigilant Torch
Other
Please provide a brief sentence outlining how we can assist:
Would you like to be followed up with by our Program Coordinator or a Former Unit Member (volunteer)?
Program Coordinator
Former Unit Member
No preference
By signing below, you acknowledge that this information was submitted willingly, with truthful knowledge, and good intent. You understand that a brief review of a military service record such as a DD-214, NGB-22, or other documents may be requested prior to providing any financial support. Lastly, you understand the foundation does not provide medical advice, opinions, or treatments directly to those requesting assistance.
For military service verification we require proof of service (i.e., DD-214, NGB-22, VA ID, DOD ID) please remove and Social Security Numbers and other sensistive information.
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Urgent Needs
If you or a loved one is in a crisis, please contact the Veteran's Crisis Line at 988-press 1, text-8389255, or go to www.veteranscrisisline.net
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