Application for Benefits
***Disclaimer: DUE TO AN EXTREMLY HIGH VOLUME OF APPLICANTS IT MAY TAKE LONGER THAN NORMAL TO QUALIFY A CLAIM****
Please read each question carefully. The more information you provide us the quicker the process goes.
Please also note that veterans that provide complete information (ie; all documents attached to this form) will be served first and if you fail to submit all documentation you're application may be automatically denied without notice. This does not mean that you can not reapply, in fact we encourage you to apply if and only when you can submit all documentation. If you have issues getting all of the information uploaded, please email it to firstname.lastname@example.org
Please enter in xxx-xxx-xxxx format
Branch of Service
Enter the total amount of years you had served.
Do you have a purple heart?
List all of your deployments and years.
Reason for Discharge
Other Than Honorable
Reason(s) for Disability
Type of Need
Please describe what you are seeking assitance for the more detailed information you can give us the better we can serve you.
Please estimate your total financial need.
Not Employed, not interested in being employed
Not Employed but would like help finding Job
Total Household Income
Please explain how this situation came about?
Go into detail as to why this situation occured? Why are you in need of assistance now?
How did you hear about us?
***READ CAREFULLY WE CAN NOT PROCEED WITH ANY CLAIM UNLESS ALL DOCUMENTS REQUIRED ARE IN OUR POSSESSION***
****Please also note that veterans that provide complete information (ie; all documents attached to this form will be served first)****
Please attach a copy of ALL of the following,
-VA awards letter even if that rating is 0%
-photo from your military service
-Photo ID (drivers license, weapons license, passport, VA Id, retirement ID, etc)
-INVOICE for the required assistance (invoice or bill must be from the company where the payment will go, please note we do not submit any sort of payments directly to veterans.)
Personally Identifiable Information Policy
Please note by checking the box below you agree to allow Cowtown Warriors to share your information with other veteran services organizations. This allows us to maxamize the benefit each applicant can receive.
Send me a copy of my responses
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