Guardian Project Application

Thank you for taking interest in the Guardian Project!

The main goal of this program is to get post-9/11 veterans dealing with PTS, MST, depression, thoughts of suicide, etc. back into the outdoors while building a larger network of peer support. You DO NOT have to be a Purple Heart recipient to qualify for this program, but those with severe injuries are welcomed to apply.

Requirements:

Must have served after 9/11/2001
Experienced trauma as a result of service
Active Duty, Retired, Honorably Discharged

This program is not for those looking to just attend a free trip. This is for veterans who are struggling mentally, physically and/or emotionally and are in need of tools and an understanding community to help them.

Applying for this program does not guarantee you placement on a trip.

Question Title

* 1. Please provide a short description of why you want to come on this trip.

Question Title

* 2. Please provide your info below.

Name (as it appears on your I.D.):

DOB: *

Address: *

City: *

State: *

ZIP: *

Cell Phone: *

Email Address: *

Nearest Airport: *

Question Title

* 3. Military Experience

Branch of Military?

Rank?

Last/Current Unit?

Date of Discharge?

Discharge Type?

Have you received any awards? (please list)

MOS (Military Occupation Specialty)?

Are you allowed to handle a firearm?

VA Rating?

Eligibility? (OIF, OEF, OND)

Question Title

* 4. Military Status?(Active Duty, National Guard, Reserve, Retired, Med Retired, Veteran)

Active Duty

National Guard

Reserve

Retired

Med. Retired

Veteran

Question Title

* 5. Were you injured during your service? (mental or physical)

If yes, please describe your injuries including any physical limitations or special conditions you may have (be specific).

Question Title

* 6. Any non-service related injuries we should be aware of?

Question Title

* 7. Any food allergies or specific diet requirements?

Question Title

* 8. Do you have combat experience?

Yes

Question Title

* 9. Please provide your height and weight.

Height:

Weight:

Question Title

* 10. What's your fitness level? (no judgement)

0 Couch Potato

100 Ultra-Marathoner

Clear

i We adjusted the number you entered based on the slider’s scale.

Question Title

* 11. In case of an emergency - please provide a family member's info.

Emergency Contact:

Emergency Phone Number:

Relationship:

Alternate E-mail:

Question Title

* 12. Family:

Married

Single

Children?

If you have children, how many and how old?

Question Title

* 13. T-shirt Size

2XL

3XL

Question Title

* 14. Tell us about your outdoor experience. (No experience necessary!)

Question Title

* 15. How did you hear about us?

Question Title

* 16. Please upload a copy of your DD214 with a blocked social.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

Find more info about the Guardian Project program here: www.whiteheart.org/guardianproject
Please contact jed@whiteheart.org with any questions or concerns.

Guardian Project Application

Question Title

* 1. Please provide a short description of why you want to come on this trip.

Question Title

* 2. Please provide your info below.

Question Title

* 3. Military Experience

Question Title

* 4. Military Status?(Active Duty, National Guard, Reserve, Retired, Med Retired, Veteran)

Question Title

* 5. Were you injured during your service? (mental or physical)If yes, please describe your injuries including any physical limitations or special conditions you may have (be specific).

Question Title

* 6. Any non-service related injuries we should be aware of?

Question Title

* 7. Any food allergies or specific diet requirements?

Question Title

* 8. Do you have combat experience?

Question Title

* 9. Please provide your height and weight.

Question Title

* 10. What's your fitness level? (no judgement)

Question Title

* 11. In case of an emergency - please provide a family member's info.

Question Title

* 12. Family:

Question Title

* 13. T-shirt Size

Question Title

* 14. Tell us about your outdoor experience. (No experience necessary!)

Question Title

* 15. How did you hear about us?

Question Title

* 16. Please upload a copy of your DD214 with a blocked social.

Question Title

* 5. Were you injured during your service? (mental or physical)

If yes, please describe your injuries including any physical limitations or special conditions you may have (be specific).