Veteran application for furniture donation - Homeland Heroes Foundation

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VETERAN APPLICATION FOR FURNITURE DONATION - Active

All veterans requesting services from HHF are required to complete this form and upload their military ID. Upon receipt of a completed application, a staff member will call to arrange an appointment to meet the veteran at one of our distribution centers: either 10 Delaware Dr. Suite 1 Salem NH or 198 Lafayette Rd N. Hampton NH. The centers are open by appointment only. Veterans must provide their own truck and ample helpers to move items. Our staff is unable to assist with moving heavy items. You will be denied assistance if these requirements are not met. We may also limit the number of items donated.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
# Of Family Members In Your Home
Have We Served You in the Past?
- Yes
- No
Agency Referred
Counselor Name and Phone Number
Other Referral & Phone Number
Other Referral & Phone Number
Branch of Military
Branch
# Of Years Served
Combat:
- Yes
- No
If Yes, Where?
Do you have any service -connected disabilities and, if so, what percent?
Items Needed
Other Referral & Phone Number
Military ID or proof of service
Drop files here or
Accepted file types: pdf, doc, doc, jpg, jpg, png, Max. file size: 30 MB, Max. files: 4.
Veteran Photo Release*
I authorize HHF staff to use the photo taken today on Facebook or for other promotional purposes.
- Yes
- No
Veteran Acknowledgement*
Veteran acknowledges that all items donated are “as is” and that Homeland Heroes Foundation is not liable for any damages or injuries that may occur as a result of these donations. I also agree to indemnify and hold harmless Homeland Heroes Foundation and any staff, Board Members or affiliates, against any and all claims, suits or actions of any kind whatsoever, for liability, damages, compensation or otherwise brought by me or by anyone on my behalf.
- Yes
- No
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

Apply For Furniture

VETERAN APPLICATION FOR FURNITURE DONATION - Active

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