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* 1. First Name:

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* 2. Last Name:

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* 3. Email Address:

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* 4. Phone Number:

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* 5. What city do you reside in?

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* 6. What state do you reside in?

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* 7. What is your zip code?

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* 8. Please explain your need:

To confirm military connection, please upload one of the following documents:
  • DD214 (Discharge Papers): This document serves as official proof of military service and can be requested through the Department of Defense.
  • VA Award Letter: A letter from the Department of Veterans Affairs confirming your benefits.
  • VA or Military ID: A valid Veterans Affairs or Military identification card.
  • VA Caregiver Support Program Award Letter (if applicable): If you are enrolled in the VA Caregiver Support Program, a copy of your approval letter will be accepted.If you do not have documentation, please reach out to our team at 202-249-7170 or financialwellness@elizabethdolefoundation.org

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* 9. Upload document here:

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