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« All Events
3rd Annual Stand Down for Veterans Cape Cod
September 27 @ 9:00 am
-
3:00 pm
«
Hyannis: NEW Food Distribution Center, 233 Stevens Street
Falmouth Food Pantry
»
Stand Down Application
Demographics
1. Relationship to the Veteran:
(Required)
I am the Veteran
I am the guest of the Veteran
I am a volunteer
I am a vendor
2. If you are the veteran, you must bring your DD-214 to the event if not already on file with CIVOC office
(Required)
I understand
N/A - Friend or Family of the Veteran
3. First Name
(Required)
First
4. Last Name
(Required)
Last
5. Phone
(Required)
6. Email
7. Age
(Required)
8. Gender
(Required)
Male
Female
Transgender
Not Singularly M or F
Questioning
Decline to answer
9. Primary Race
(Required)
White
Black, African American, or African
American Indian, Alaska Native, or Indigenous
Asian or Asian American
Native Hawaiian or Pacific Islander
Declined
10. Ethnicity
(Required)
Non-Hispanic/Latin(a)(o)(x)
Hispanic/Latin(a)(o)(x)
Declined
11. Your Housing Situation
(Required)
Permanent & Stable Housing
At-risk of losing housing / Temporarily Housed
Homeless*
*in a place not meant to be lived in or in a temporary program but otherwise homeless.
12. Length of time homeless:
13. Current City, State, & ZIP
(Required)
City
State / Province / Region
ZIP / Postal Code
14. Is your current address a Cape & Islands Veterans Outreach Center Residential Site?
(Required)
Yes
No
15. Your Cape & Islands Veterans Outreach Center location:
Dennis Veterans Home
Grace Family Veterans Home (Hyannis)
16. Check below the programs you are currently enrolled in:
(Required)
SSVF
Temporary Housing / Shelter
Employment & Training, CODE
Food Pantry
Outreach Services
Counseling Services
Other
None
17. Check below any of the Veterans Programs you are interested in:
(Required)
Temporary Housing / Shelter
Financial Assistance for Housing (SSVF)
Employment & Training
Food Pantry
Outreach Services
Transportation
Counseling Services
Other
None
18. Branch of Service
(Required)
Air Force
Army
Coast Guard
Marine Corps
Navy
Space Force
N/A - Friend or Family of the Veteran
19. Select below the Financial Benefits you receive:
(Required)
Employment
Unemployment Insurance
VA Service-connected Disability
VA Non-Service Pension/Disability
SSDI
SSI
Retirement from Social Security
State Assistance
Pension/Retirement from former job
Other
None
20. Sources of Non-Cash benefits:
(Required)
SNAP (Food Stamps)
WIC
Child Care Services
TANF
Other
None
21. Employed:
(Required)
Yes
No
22. What prevents you from being employed?
Disabled
Retired
In School
Unable to find work
Other
None
23. Is this your first Veterans Stand Down Event?
(Required)
Yes
No
24. How did you hear about Stand Down?
(Required)
Flyer
The Cape and Islands Veterans Outreach Center Web Site
The Cape and Islands Veterans Outreach Center Employee
Word of Mouth
Council on Aging / Senior Center Newsletter
Chamber of Commerce
Social Media
Other
25. Who helped you complete this registration?
(Required)
No one, I completed it myself.
The Cape and Islands Veterans Outreach Center Staff / Volunteer
Veterans Service Officer (VSO)
Volunteer
Other
26. Marital Status:
(Required)
Single
Married
Separated
Divorced
Widowed
27. Education:
(Required)
High School/GED
Associates Degree
Bachelors Degree
Masters Degree
PHD
Other
28. Discharge Status:
(Required)
Honorable
Medical
General
Other
Bad Conduct Discharge (BCD)
Dishonorable Discharge
N/A - Family or Friend of Veteran
29. Era of Service:
(Required)
World War II
Korea
Vietnam
Lebanon
Grenada
Persian Gulf
Peace Time
Afghanistan
Iraq
Other
N/A - Family or Friend of Veteran
IMPORTANT THINGS TO NOTE:
A FLU CLINIC, CARDIO CHECK, AND BONE DENSITY SCAN WILL BE AVAILABLE FOR ALL ATTENDEES. INSURANCE CARD REQUIRED FOR THE FLU CLINIC. THERE WILL BE A BLOOD DRIVE HOSTED AT THE EVENT IN THE CAPE COD HEALTHCARE BLOOD MOBILE
See you Friday, September 27, 2024!
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Details
Date:
September 27
Time:
9:00 am - 3:00 pm
Event Category:
Special Events
Venue
Irish Village HyPort Conference Center
35 Scudder Avenue
Hyannis
,
MA
+ Google Map
View Venue Website
Related Events
Veterans Rendezvous Cafe Barnstable
September 19 @ 9:30 am
-
11:00 am
Veterans Round Table Discussion
September 19 @ 2:00 pm
-
4:00 pm
Vets Cook with KAM Appliances
October 23 @ 9:30 am
-
11:00 am
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