Grant Application | Military Heroes

Eligibility Criteria

Minnesota Taxpayer or a Non-Minnesota taxpayer assigned to a Minnesota Military Unit
All branches of service-enlisted and reserve military personnel
Served in a designated Combat Zone anywhere in the world
Served after September 11, 2001
Active service or honorably discharged providing your DD214

The reason for loss of income was due to

Illness Injury Natural Disaster Activation or Mobilization Death

Nature of Incident

Date of Incident

Location of Incident

If you were injured and awarded a Purple Heart Certificate, please list the date of injury And attach a copy of your Purple Heart Certificate and a copy of the Incident Report.

Have you made previous application?

Yes

If 'Yes,' give date and place

*Please attach a summary statement of why you need this grant. The information you provide will help the board determine the worthiness of your needs.

Personal Information

Social Security Number

Folio No.

Last Name

Rank - First Name

Initial

Date of Birth

Permanent Mailing Address (Check Disbursement address)

City

State

Zip Code

County

E-Mail Address *

Day Phone Number

Evening Phone Number

Military Information

Branch of Service

State of Legal Residence

Name of Home Unit and Phone

Combat Location Served

Start Date

End Date

First Name

M.I.

Last Name

Social Security Number

Date of Birth

Relationship to Veteran

I am requesting a non-taxable grant, and to the best of my knowledge, certify that the above information is true and accurate. I understand BMMHF has the right to reduce the size of a grant or discontinue awarding grants whenever BMMHF deems necessary. I understand that BMMHF will award one grant per applicant but if I am injured on a later tour, I may re-apply or in the event of my death, my beneficiary may re-apply for an additional grant. BMMHF will not disclose any nonpublic personal or military information about its applicants to any third party, except to the extent BMMHF deems necessary to validate the information provided on this application. Filling out this online form indicates acceptance of the foregoing conditions.

Would you be willing to give a testimonial of our organization and photo?

Yes No thanks

Attachments