Coalition to Salute America's Heroes

Providing Emergency Financial Aid and Other Services to Veterans Severely Wounded in Iraq and Afghanistan

Program Application for Emergency Financial Aid

You sacrificed. We are here to help.

The mission of the Coalition to Salute America's Heroes is to assist veterans who have been severely injured while serving in Operation Iraqi Freedom and Operation Enduring Freedom, and their families, and to encourage other organizations and the general public to participate in this effort.

To be considered for Emergency Financial Aid, applicants must meet the following minimum eligibility requirements:

Please note that while the Coalition wishes we could help all qualified individuals who seek assistance, regrettably we only have limited funds to meet the needs of qualified veterans. Therefore, we can only respond to requests based on our available resources.

Please also note that the Coalition sincerely respects your privacy. The information you provide below will be kept confidential and not shared with any third party.

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NOTICE

The completion of this application does not guarantee the awarding of emergency financial assistance from the Coalition to Salute America's Heroes.

Please note that while the Coalition wishes we could help all qualified individuals who seek assistance, regrettably we only have limited funds to meet the needs of qualified veterans. Therefore, we can only respond to requests based on our available resources.

The applicant agrees that the name appearing in the signature block below is the true and legal name of the applicant and serves as an electronic "signature" to this application. Further, the applicant attests to the fact that the information contained herein is true and accurate to the best of the applicant's knowledge.

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Coalition to Salute America's Heroes
552 Fort Evans Road, Suite 300
Leesburg, VA 20176
703-291-4605
www.saluteheroes.org