VNGF GRANT APPLICATION Applicant InformationDate Member Name(Required) First Middle Last Work Status(Required)Select your work statusAGRTraditional/M-DayADOS/TraditionalDMA Civilian/Technician/T-5Not SureRank(Required)Rank-------- Army Ranks -------PVTPV2PFCSPCCPLSGTSSGTSFCMSG1SGSGMCSMWO1CW2CW3CW4CW52LT1LTCPTMAJLTCCOL------- Air Force Ranks -------ABAmnA1CSrASSgtTSgtMSgtSMSgtCMSgt2d Lt1st LtCaptMajLt ColColPay Grade(Required)Have you been deployed(Required)Have you been deployed?YesNoUnknownDo you have a VA rating(Required)Do you have a VA ratingYesNoUnknownMarital Status(Required)Select StatusSingleMarriedDivorcedWidowedUnknownAre there others in your household(Required)Select answerYesNoLanguage(Required)Select LanguageEnglishSpanishOtherOther LanguageType the language preferred. Are you working with a Soldier and Family Readiness Specialist(Required)Army - Soldier and Family Readiness Specialist ----- Air - Family Programs Yes No Name of the person you are working with(Required)Have you received assistance from any other organization(Required)Select answerNoYesPendingHave you received a Virginia National Guard Foundation Grant before?(Required)Select answerNoYesPrevious Grant Date Preferred Contact Method(Required)Select Contact methodPhoneEmailTextSocial MediaIn-PersonMember Civilian Email(Required)Use the email you can most easily be contacted with. Phone Number(Required)Is this a mobile number?(Required)Select if this is a mobile number and if you can receive text message on this number. Mobile with Text Capability?NoYes, but no text capabilityYes, with text capabilityMember Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Virginia National Guard Assigned PositionComponent(Required)ComponentAir National GuardArmy National GuardUnit/Department(Required)Current unit you are assigned to Unit Location / Address(Required)Location of your current unitReason for Emergency Assistance(Required)Describe in detail why this grant is needed and whom the funds should be directed to. This will also assist VNG Family Programs in understanding your needs and which programs are best suited for your situation. The intended purpose of this Grant is for:(Required)Select PurposeCar RepairChild CareDeployment IssueMedical/Dental ExpensesMilitary Pay IssueMortgage/RentPersonal EmergencyTransportationUtilitiesOtherEstimated Dollar Amount Needed(Required)Supporting DocumentsUpload any supporting documents Drop files here or Select files Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB, Max. files: 3. Signature(Required)Your NameYour NameYour NameYour NameSignatureEnlisted - Chain of Command (FULLTIME)Readiness NCO / NCOIC Name(Required) First Last NCOIC Rank(Required)Rank-------- Army Ranks -------PVTPV2PFCSPCCPLSGTSSGTSFCMSG1SGSGMCSMWO1CW2CW3CW4CW52LT1LTCPTMAJLTCCOL------- Air Force Ranks -------ABAmnA1CSrASSgtTSgtMSgtSMSgtCMSgt2d Lt1st LtCaptMajLt ColColNCOIC Position(Required)NCOIC Email(Required) NCOIC Phone(Required)Civilian SupervisorSupervisor Name(Required) First Last Grade / Rank(Required)Rank / GradeCivilian Grade-------- Army Ranks -------PVTPV2PFCSPCCPLSGTSSGTSFCMSG1SGSGMCSMWO1CW2CW3CW4CW52LT1LTCPTMAJLTCCOL------- Air Force Ranks -------ABAmnA1CSrASSgtTSgtMSgtSMSgtCMSgt2d Lt1st LtCaptMajLt ColColSupervisor Civilian Grade(Required)Position(Required)Email Supervisor(Required) Phone(Required)Officer - Unit CommanderOIC Name(Required) First Last OIC Rank(Required)Rank-------- Army Ranks -------PVTPV2PFCSPCCPLSGTSSGTSFCMSG1SGSGMCSMWO1CW2CW3CW4CW52LT1LTCPTMAJLTCCOL------- Air Force Ranks -------ABAmnA1CSrASSgtTSgtMSgtSMSgtCMSgt2d Lt1st LtCaptMajLt ColColOIC Position(Required)OIC Email(Required) OIC Phone(Required)CommanderCommander Name(Required) First Last Commander Rank(Required)Rank-------- Army Ranks -------PVTPV2PFCSPCCPLSGTSSGTSFCMSG1SGSGMCSMWO1CW2CW3CW4CW52LT1LTCPTMAJLTCCOL------- Air Force Ranks -------ABAmnA1CSrASSgtTSgtMSgtSMSgtCMSgt2d Lt1st LtCaptMajLt ColColHaving issues with this form please call the emergency hotline 1-434-480-6585 Contact The Virginia National Guard Foundation Name Email Address Phone Message Submit 804.223.1332 PO BOX 37037Richmond, VA 23234 Make a Donation
