BECOME A COMMUNITY PARTNER

COMMUNITY PARTNER APPLICATION

Please fill out the form below to apply to become a community partner at the

2024 Wayne D. Horner Memorial Stand Down Madison. October 19, 2024

Organization Name

Contact Person

Address

Phone Number

Type Of Service Offered (Choose Top 3)

Employment/Training

Education

Financial/Benefits

Health/Wellness, and Recovery

Housing/Utilities

Legal

Medical/Mental Health

Personal Needs (Haircuts, Hygiene, Clothing)

Spiritual Growth/Spirituality

Transportation

Veteran Service Organizations

Other

Enter Other Service Offering Here

Email

Please enter a brief description of what your agency will provide to the veterans.

T-Shirt Size (SM-4XL)

What will you need the day of the event?

How many people from your agency will be attending?

Considering all of your volunteers, how many volunteer hours will you likely contribute during the event?

How many years has your agency participated in the Wayne D. Horner Stand Down?

Please provide your web address.

Preferred Contact Method *

Mail

Email

Phone

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