Emergency Assistance Request Form
If you are a FUM or UM, you are eligible. You do not have to fill out this form, you may contact any Vigilant Torch member or staff directly, or contact your chain of command (if a UM). This form is one of many ways to get a hold of us to request support.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Which best describes your status
*
Please Select
UM (Active Duty Service Member)
UM (DA Civ)
FUM
If you are a FUM, and you are NOT a Vigilant Torch member, please provide a very brief description of when you were a UM (for vetting).
If you are, or were, a service member, what MOS? (if you are not Army, state which branch and your job code)
We use this not to discriminate, instead, this allows us to find resources that may assist you.
Please briefly describe your situation and the support your are requesting.
*
What to expect next:
We will reply back to you ASAP. If you don't hear back from us in a timely fashion, you can email Brian Gellman at briang@vigilant-torch.org.
Disclaimer:
Every situation is unique, and we handle each situation differently. The more information you provide us, the more resources we may be able to access to assist you.
Submit
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