The Veterans Project

Pre-registration for November 17th Stand Down in Venice
Call Annie Fennell at 310.478.3711, ext. 40187, or fill out and submit the form below.

Name *

First

Last

Street address, city, state and zip code *

Phone number (home and/or mobile) *

Social Security # *

Date of Birth *

Email *

Branch of Service *

Dates of Service *

Type of Discharge *

Are you currently homeless? *

No Yes

Do you have a DD-214 form (not required)? *

No Yes

Do you have a picture ID (not required)? *

No Yes

What services are you seeking? *

Medical Legal Housing Job/Career/Mentoring Other

Please specify if you checked "Other" *

Comment/Question/Suggestion *

Submit

Click here for more info about the Stand Down.