• Applications

We ask that you fill out this application to help us determine if you qualify for monetary assistance from our organization. Please fill out this application completely and as accurately as possible.

All information obtained in this application will be kept confidential.

Person Applying for Applicant (if not Applicant):

Applicants Name:

Street Address:

City:

State:

Zip Code:

Email Address:

Cell Phone:

Home Phone:

DOB:

Current Employment:

Marital Status:

Dependents: (please use one line per dependent)

Please explain your need:

Expenses (Monthly)

Rent/ Mortgage

Electricity

Gas

Heating Fuel

Car Payment

Car Insurance

Health Insurance

School Lunches

Food

Child Care/Support

Credit Card debt

Student Loans

Medical

Other (Please specify)

Total Monthly Expenses

Gross Income (Monthly)

SSI

Disability

Comp & Pen

Child Support

Wages Applicant

Wages Spouse

Total Monthly Income

DD214 is required to complete Application

Please upload your DD214 (required)

Please upload any additional documents (optional) i.e. debts/income, supporting current bills/documents

Signature (typing your name serves as your signature)

Full Name:

Date:

COMMITTEE FOR THE FAMILIES OF WAR VETERANS

© 2018 Committee For The Families of War Veterans. All Rights Reserved.

ABOUT US

We are a non-partisan, 501C3 not-for-profit organization based in the greater Hudson Valley area of New York. The Committee was founded in 2007 to raise funds for returning veterans, current soldiers, as well as the families of soldiers wounded or killed in combat.

CONTACT US

Our Address:
Committee for the Families of War Veterans
55 W. Railroad Avenue Bldg. 24C 1st Floor
Garnerville, NY 10923

e-mail us
(800) 221-4742