Veteran Registration Form
(Please complete the fields below and click submit when finished.)
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Birthday
-
Month
-
Day
Year
Date
How did you hear about us?
Friend/Family/Colleague
Social Media
Veterans Organization
Other
What branch of the military did you serve in?
Air Force
Army
Navy
Marines
Space Force
Which membership type are you interested in?
PATRIOT (Service-connected Veteran student / No dues)
AMBASSADOR (A dues-paying Veteran volunteer)
Preferred method of contact
Email
Phone
Text
Any
Membership Rules:
Membership is open to any service-connected Veteran, as designated by the VA.
This is a 2-year curriculum. At the end of two years, student Veterans (PATRIOTS) may choose to remain as a non-dues paying member, or can advance to a dues-paying Veteran volunteer (AMBASSADOR).
There is no time limit to membership. We promote a healthy community on your terms.
I have read, understood and accept the rules of membership.
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