Veteran's Club Veterans Village

Preferred Contact Method *
What Branch(es) of the Military did you serve in? *
Do you have a copy of your DD214 / NGB 22 available? *
Discharge Status *

Do you qualify for Military Benefits? *
Have you deployed to a Combat Zone or in support of Combat Operations? *
Deployment Locations *
Do you have a Certified Service Animal *
Do you have a vehicle? *
Do you use tobacco / nicotine? *
Do you use alcohol? *
Do you have a history of addiction? *
Are you using any medications that are not prescribed to you? *
Have you every been convicted of a crime? *
Have you ever been convicted of a felony? *
Have you ever been charged with or convicted of a sex related offense or are you on the sex offender registry? *
Have you ever been diagnosed with any mental health disorders? *
Are you currently employed? *
Are you homeless or facing homelessness? *
Do you have a mailing address? *
Terms and Conditions *
I hereby certify that I am at least 18 years of age. Applicant represents that all information given on this application is true and correct. Applicant hereby authorizes verification of all references and facts, including but not limited to current and previous landlords, employers, and personal references. Applicant hereby authorizes Veteran’s Club to obtain any and all Unlawful Detainer, Credit Reports, Telechecks, and/or Criminal Background Reports. Applicant hereby waives any claim and releases from liability any person providing or obtaining said verification or additional information. Please sign *
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