Stand Down 2021 Participation Form

This event is for homeless veterans, veterans at risk of homelessness or unemployed.

Last Name (required)

First Name (required)

Last Four Digits of Social Security #

Cell Phone #

Email

Ethnicity:
WhiteAfrican AmericanHispanic/LatinoAsianNative AmericanOther

Date of Birth

Branch of Service:
ArmyMarine CorpsNavyAir ForceCoast GuardActive Reserve

Character of Discharge:
HonorableGeneralOthBCDDishonorable

Have you attended Stand Down in San Diego Before:
YesNo

What services are you looking for (check all that apply):
HousingEmploymentLegalMedicalDentalTreatmentCounseling