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ARE YOU A U.S. VETERAN?
submit your application to win a FREE car!
Please join us
Sunday, October 2nd, 9 AM at the VFW Post 4031
for our Veterans Benefit Breakfast where the recipient of the car will be announced.
Please Note - You must be present to win!
Fill out the form below or download and print the application:
Download and Print
Date
Date of Birth
First Name
Last Name
Mailing Address
Email Address
Phone(s)
Driver's License #
State
DL Expiration Date
By checking this box, I give permission for VFW post 4031 to obtain my driving record.
Note: DD214 or other supporting documents must be provided at time of drawing in order to win.
Number of dependents living in your household
Ages of Dependents
Please check this box if you are receiving compensation/benefits of any kind from the government.
If so, please explain
Have you previously applied for help from another non-profit organization?
If so, name of organization and date applied:
In the event you are chosen to receive the car, do you understand you are required to obtain and hold vehicle insurance, as well as keep the vehicle registered?
Brief Summary/Explanation
I hereby certify that all the information provided by me in this entry form (or any other accompanying or required documents) is correct, accurate and complete to the best of my knowledge.
Thank you! Your submission has been received. ;)
Please plan on bringing your DD214 or other supporting discharge documents with you to the breakfast on
Sunday, October 2nd, 9am
at
VFW Post 4031
1550 Main Ave
Durango, CO
81301
We'll see you there!
Oops! Something went wrong while submitting the form.
REMEMBER - You must be present to win!
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