LVAP HOURS
Record your Number of Hours for Local Veteran Assistance Program
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Month
*
Last four of SSN
*
Are you a Member of DAV Arlington-Fairfax Chapter 10 or Auxiliary Unit 10
*
Yes
No
Category
*
A: Chapter/Department Service Work (CSO/DSO) (Set up for events, maintenance and cleaning).
Number of Hours
*
Category
*
B: Fundraising Efforts (Forget-Me-Nots and other approved Chapter /Unit fundraisers)
Number of Hours
*
Category
*
C: DAV Specific Outreach Efforts (Outreach Programs, Veteran Stand-downs, funerals, Honor Guard, planning meeting for veteran activities)
Number of Hours
*
Category
*
D: Veteran Assistance (Direct assistance to veterans, survivors, or families to include yard work, home repairs, grocery shopping)
Number of Hours
*
Are you receiving Chapter 10's newsletter?
*
Yes
No
Are you following Chapter 10 on Facebook?
*
Yes
No
Are you following Chapter 10 on Twitter?
*
Yes
No
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform