WDVA Emblem Fund Application
The 2019 Application Period has closed. You may submit an application using this form; however, funds will likely not be available again until 2021.

The WDVA Emblem Fund Policy is available online at: http://www.dva.wa.gov/about-wdva/veterans-affairs-advisory-committee .

Please ensure all fields are completed before submitting your application to WDVA. Incomplete applications will not be considered.

If you have any questions or need assistance, please contact Rene at 360-725-2167 renem@dva.wa.gov or Heidi at 360-725-2154 heidia@dva.wa.gov
Email address *
1. Describe below how this project pays tribute to living or deceased veterans. (20 pts) *
(max 2500 characters)
Your answer
2. Identify how maintenance and upkeep will be funded. (20 pts) *
(max 2500 characters)
Your answer
3. Describe your organizations purpose and goals. (20 pts) *
(max 2500 characters)
Your answer
4. Describe the project in detail. If copies of drawings, plans or blueprints are available, please indicate in narrative. (20pts) *
(max 2500 characters)
Your answer
5. Detail the total cost of the project including all sources of funds collected or pledged, including in-kind contributions. (20 pts) *
(max 2500 characters)
Your answer
6. Specify the amount of funds requested from the Veterans Emblem Account and how the will be spent. (max 50 words) *
Your answer
7. Fax, Email or Mail a completed IRS Form W-9 to: FAX 360-586-4393, renem@dva.wa.gov or WDVA Attn Rene Morales PO Box 41150 Olympia, WA 98504. *
Please indicate how you will be submitting this information. W9 Form available at: http://www.irs.gov/uac/Form-W-9,-Request-for-Taxpayer-Identification-Number-and-Certification
Your answer
8. Fax, Email or Mail a copy of your IRS 501 (C)(3) documentation; or Incorporation Documents; or Proof of Government Status to: FAX 360-586-4393, renem@dva.wa.gov or WDVA Attn Rene Morales PO Box 41150 Olympia, WA 98504. *
Please indicate how you will be submitting this required information:
Your answer
9. Include the organization's name and the name, email, phone number and mailing address of the individual who may be contacted regarding the proposed project. *
Your answer
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