San Antonio Retreat for Veterans, Service Members & Families 2010

We welcome all veterans and active duty military personnel who have been deployed to Iraq or Afghanistan since Sept. 11, 2001 and their families. (Including: children, single veterans, wounded warriors, surviving family members and all family types.) Everyone is welcome as they are and all are treated with respect.

Please complete the entire application below. Information provided will be kept confidential. Incomplete applications will not be reviewed. A complete application means that you and every other adult with whom you wish to attend has completed a separate online application. If you are a Gold Star Family, your service member is currently deployed, or he/she will not be attending with you-- we will need proof of military service submitted with your application.

Please only apply for ONE 2010 retreat--applying for more than one retreat will result in duplicate applications and your information will not be reviewed. At the bottom of your application you may note your preferences for second and third retreat locations in the event that you are not admitted to your first choice. The retreat to which you applying should be the location CLOSEST TO YOUR HOME . Priority will be given to complete applications and proximity to retreat locations.

If you are having trouble with your online application please email contact@cominghomeproject.net or call 415-353-5363 between 9AM-5PM PST. Thank you.

Information about You

Please note that each group MUST have a veteran or service member complete an application and submit a DD214 or copy of a military ID to have the application considered. If you are a Gold Star Family, your service member is currently deployed, or he/she will not be attending with you-- we will need proof of their military service in the next section.

EACH adult over 18 years of age, must complete their own application. Children under 18 years of age, must have their information submitted on an adult application.

First Name: *

Last Name: *

Date of Birth: *

mm/dd/yyyy

Primary Phone: *

123-456-7890

Cell Phone: *

123-456-7890; May be the same as primary phone.

Email Address: *

Street Address: *

City: *

State: *

Zip Code: *

Are you a veteran or service member?: *

What is your relationship to the veteran or service member?: *

If "other," please specify:

Why would you like to attend the retreat?: *

What would you like to get from this retreat?: *

Information about Service Member or Veteran

Please fill out this information about the veteran or service member with whom you are attending (if you are a veteran or service member, this refers to you). If you are a Gold Star Family, your service member is currently deployed, or he/she will not be attending with you-- we will need proof of their military service submitted with your application.

Veteran's Full Name: *

Should match government issued ID

Has veteran or service member served since September 11, 2001?: *

Military Unit:

Number of Deployments Completed Since 9/11/01: *

Country(s) and dates of deployments: *

(mm/yyyy)

Evidence of Military Service:

Please upload a scanned version of either:
DD214, Copy of current Military ID, or copy of most recent paystub here
OR
Fax to 415-353-5794 (include your name and contact number somewhere on the document)

Applications will not be considered complete until this documentation is submitted.

Additional Information

Are there other adults in your group who have completed or will complete an online application with whom you would like to attend? If so, please list their full names in the spaces provided below.
-Please NOTE: Each adult that you list here is required to submit their own application as we are requiring that EACH adult applicant complete an online form.
-If you have more than FOUR additional adults who wish to attend with you and are submitting their own application please contact 415.353.5363, so we can match your applications.

Additional Adult:

Please list Full Name for other adult (18+) who is submitting their own application.

Additional Adult:

Please list Full Name for other adult (18+) who is submitting their own application.

Additional Adult:

Please list Full Name for other adult (18+) who is submitting their own application.

Additional Adult:

Please list Full Name for other adult (18+) who is submitting their own application.

Child Information

Please list all children who are planning to attend the retreat with you. If you have more than FIVE children attending, please contact 415.353.5363.

Child Name:

Please list FULL NAME/AGE for each child (under 18 yrs) who is attending with you.

Child Name:

Please list FULL NAME/AGE for each (under 18 yrs) who is attending with you.

Child Name:

Please list FULL NAME/AGE for each child (under 18 yrs) who is attending with you.

Child Name:

Please list FULL NAME/AGE for each child (under 18 yrs) who is attending with you.

Child Name:

Please list FULL NAME/AGE for each child (under 18 yrs) who is attending with you.

Including you, list total number of attendees in your group (adults and children): *

Please include yourself, adults and children in your family.

Medical Information

Please complete the medical form and upload it below.
You may also print your medical form and fax it in at 415-353-5794. Medical Information will not factor into selection or eligibility. We make every effort to accommodate special needs where possible.

Adult Medical Form

Youth Medical Form

Adult Medical Form: *

Please upload your completed medical form here.

Youth Medical Form: