North County Veterans Stand Down Veteran Registration Form
The North County San Diego Veterans Stand Down will occur at Green Oak Ranch in Vista from 12:00 NOON Thursday January 25 through 12:00 NOON Sunday January 28, 2018. Pre-Registration is required and your registration will be confirmed by phone or email.

Please help us serve you by answering the questions below and submitting your registration form! For security reasons, we are unable to serve Veterans who are registered sex offenders. If you have additional questions, please call (866) 535-2038 Ext 1.

Last Name *
Your answer
First Name *
Your answer
Middle Name
Your answer
Social Security Number *
Your answer
Driver's License State & Number *
If you do NOT have a driver's license, please enter '0'
Your answer
Did you serve in a war zone? *
If you answered yes, where did you serve?
Branch of Service *
Dates of Service (MM/YY to MM/YY) *
Your answer
Birthdate (MM/DD/YYYY) *
Your answer
Are you currently supported by another organization? *
Please provide us your phone#, email address or other way to find you. *
Please provide a phone number or email address where we can contact you to confirm your submission and schedule any ID card or legal appointments.
Your answer
What is your gender? *
Are you interested in receiving more comprehensive support: employment, mentorship, and housing? *
If Yes, someone from our team will contact you.
Please list any current health problems *
If you have any legal issues, please indicate:
Your answer
Would you like to attend Veterans Court? *
Veterans court will take place during the Stand Down and is scheduled in advance. Requests for Veterans Court must be submitted by Jan 5, 2018.
Do you have a child support case being administered by San Diego County D.C.S.S? *
Will a spouse or partner be attending with you?
If yes, please provide their full legal name.
Your answer
Will any of your children (under the age of 18) be attending with you?
If yes, please provide their full legal name(s).
Your answer
Do you plan on bringing a pet with you to the event? *
If you have any special needs such as wheelchair access, please indicate:
Your answer
Please select your pick-up / drop-off location. *
Buses will provide transportation to the Stand Down from 11am-4pm on Thursday Jan 25th, 2018.
Emergency Contact Name:
Your answer
Emergency Contact Phone:
Your answer
By checking this box, you confirm that you have never been convicted of a sex offense. *
All participants will be screened for a history of sex offense.
Terms of Acceptance and Signature
I, (the applicant) for this Registration Form, warrant the truthfulness of the information provided in this application. Any false information will result in the automatic forfeiture of participation in all Stand Down activities.
Please type your first and last name here for electronic signature *
Your answer
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance. *
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