Stealth Werks Recipient Application

Thank you for your interest in the Stealth Werks Veteran Simulator Program. This application helps us better understand your military service, current situation, and how this equipment may positively impact your life.

There are no right or wrong answers. We simply ask that you answer each question honestly and completely.

Every application is carefully reviewed by the Stealth Werks Selection Committee to make thoughtful and fair decisions based on the information provided, program goals, overall fit, and available resources.

Estimated completion time: 10 to 15 minutes

Before You Begin:

Please have the following information available before starting your application:

Required:
- Contact information
- Military service information
- A brief professional recommendation from a licensed healthcare or mental health professional (a one-page letter is sufficient).
What You'll Receive

If selected, you'll receive a complete home sim racing setup, professionally delivered and assembled by Stealth Werks. While equipment may vary based on availability and future program updates, a typical setup includes:
- Trak Racer racing cockpit
- Moza Racing direct drive wheelbase
- Moza Racing steering wheel
- Moza Racing pedals
- Gaming PC
- Gaming monitor
- Keyboard and mouse
- One year of iRacing membership
- Delivery, assembly, setup, and orientation by Stealth Werks
- Access to the Stealth Werks Discord community and league racing program
What to Expect:
- Your application will be reviewed by the Stealth Werks Selection Committee.
- Submission of an application does not guarantee selection.
- If additional information is needed, we will contact you using your preferred method of communication.
- If selected, Stealth Werks will schedule a visit to personally deliver, assemble, and test your simulator in your home.
Optional:
- DD214 or other proof of military service
- Additional letters of support
- Any other supporting documents you would like the review committee to consider
Privacy
Information submitted through this application will be used solely for evaluating your application and administering the Stealth Werks Simulator Assistance Program. We respect your privacy and will handle your information with care.
Required
Fields marked with * are required to submit your application.

Stealth Werks Veteran Application

Helping veterans find focus, purpose, and relief through immersive racing experiences, with a focus on PTSD and TBI recovery.
Recipient Agreement
If selected, you will be asked to review and sign a Recipient Agreement before your simulator is delivered.

The Agreement explains the responsibilities of both Stealth Werks and the Recipient and includes topics such as:
- Temporary ownership of the original donated equipment during the first year, after which ownership transfers to the Recipient in accordance with the agreement.
- Care and proper use of the equipment.
- Equipment upgrades and replacement components.
- Warranty information and technical support.
- Delivery, installation, and equipment inventory procedures.
- Community opportunities, including Discord and league racing.
  privacy, media, and optional livestream permissions.
The full Recipient Agreement will be provided to selected recipients before delivery. You will have the opportunity to review it carefully and ask questions before signing.
Name

First NameLast Name
Address

Street Address

CityState / Province

Postal / Zip Code
Preferred Contact Method
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
If we need to contact you regarding your application, what is the best time of day to reach you?

Branch Of Service
Service Start Year
Service End Year
Type Of Discharge
Do you have a VA service-connected disability?
Please tell us about your military service. Feel free to include duty stations, deployments, military occupations, awards, or anything else you would like the review committee to know.

Are you currently employed?
Do you currently rent or own your home?
What type of internet connection do you currently have?
The simulator requires a minimum footprint of approximately 56" long by 30" wide. We recommend a total space of at least 60" long by 46" wide to allow for entry, exit, and maintenance.
Do you have adequate space available in your home for this setup?
Where do you plan to set up the simulator in your home?
Examples: spare bedroom, basement, living room
If selected, Stealth Werks will personally deliver and assemble your simulator to ensure it is installed correctly, operating properly, and ready to use. If selected, are you comfortable allowing Stealth Werks representatives to enter your home for delivery and installation?
To help ensure the safety of our volunteers and protect the donated equipment, recipients are expected to provide a clean, safe, and accessible installation area. If significant safety or environmental conditions are identified during delivery, Stealth Werks reserves the right to postpone or decline installation until those concerns have been addressed.
Do you have any mobility limitations or accessibility needs we should be aware of when planning your simulator setup?
If yes please describe any specific accommodations or modifications that would help make the simulator more comfortable and usable for you.
Please tell us how receiving a Stealth Werks simulator could positively impact your daily life.

Supporting Documents
DD214

If available, you may upload a copy of your DD214 or other documentation verifying military service.
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Professional Recommendation (Required)
To help us make thoughtful, informed decisions, all applicants are required to submit a brief letter from a licensed healthcare or mental health professional who is familiar with their care. This may include a psychologist, psychiatrist, licensed professional counselor, physician, physician assistant, nurse practitioner, licensed clinical social worker, VA provider, or Vet Center counselor. The recommendation does not need to include diagnoses, medical records, treatment notes, or other personal medical information. A brief, one-page letter explaining why the provider believes participation in the Stealth Werks Simulator Assistance Program may positively benefit your overall well-being, recovery, or quality of life is sufficient. The purpose of this recommendation is not to verify a diagnosis, but to provide the healthcare professional's opinion regarding how participation in the Stealth Werks Simulator Assistance Program may benefit the applicant.

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Additional Letters of Support (Optional)
Letters from family members, fellow veterans, friends, employers, mentors, or others who know you personally are welcome but are not required.

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Required Acknowledgment
Final Verification
Should be Empty:

Stealth Werks Veteran Application

Supporting Documents