Combat Veteran Application

Applicant Name
Date of Birth

MonthDayYear
Date
Address
Phone
Email
example@example.com
Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Email
example@example.com
Social Media Links FB or IG
Rank
Branch of Service
Years in Service
Deployments and Dates

MonthDayYear
Date
2nd deployment date

MonthDayYear
Date
3rd deployment date

MonthDayYear
Date
Purple Heart Recipient
Other Medals
Shirt Size
Disability Percentage
Combat Disability?
List any limitations anything we may need to assist you with
Are you Proficient with Archery?
Please explain what a hunting and fishing event would mean to you and why you should be considered
If you arent proficient with archery, would you like to be?
Would you rather fish, hunt or hike?
What would you like to be considered for the most
Do you hold any points for any states that if you were drawn you could go
Thank you for filling out your application with us. Also you will need to email crystal@veteransoutdooortherapy.org and attach your DD214 and VA award letter for a submission to be considered complete. We are limited to events and funding but will do our best to get you in.
Should be Empty: