Operation Ward 57 · Small Grant Application

Our main goal under Operation Ward 57 is to enhance the lives of wounded warriors by providing support in order to improve the mental health and wellness of those struggling to overcome the burdens of war. Members of the United States Military put their lives at risk in the service of our country. Many suffer severe and often permanent psychological and physiological disability in the line of duty. Grants for these wounded heroes provide financial assistance in addition reducing the heavy burdens encountered as a result. This financial and emotional respite is a small gesture we can provide as a thank you for their sacrifice.
Please complete the following application to be considered for a one-time grant up to $250 from Operation Ward 57. Those eligible include post 9/11 active duty military personnel, career or medically retired military, or those honorably discharged from service who have been injured, wounded or acquired a disease during service (VA rating of 60% or higher). Eligibility is also extended to the immediate family members if they are a caregiver or NMA. Examples of small grants we might fund: temporary financial assistance, shelter, food, utilities & health expenses, assistance with child care, other routine household expenses, home & vehicle adaption, funeral expenses, adaptive equipment, moving assistance, travel, etc. Grant money is paid directly to the person or company owed the debt, such as a landlord or electric company whenever possible. Incomplete applications will not be considered. Submitting an application does not guarantee funding. The amounted funded is up to the discretion of Operation Ward 57 and may not equal the funds requested. Requests over the $250 limit will be considered on a case by case basis. Emergency grant applications will be handled on a case by case basis. For non-emergent applications expect up to 2 weeks for your application to be reviewed and receive a response. All decisions will be emailed to the email address provided for the service member. IT IS HIGHLY RECOMMENDED THAT THIS APPLICATION BE SUBMITTED BY A CASE MANAGER (VA, AW2, SOCIAL WORKER, ETC). Completion of this application acts as a Release of Information for all parties listed on the application and case managers or unit contacts may be contacted to verify information.

Grants may only be received 1 time in a 12 month period or at the discretion of the Operation Ward 57 staff.

Examples of items we do not fund include vehicle repairs, credit card debt, medical, childcare or school expenses.

Contact Information

Date

*

(mm/dd/yyyy)

Service Member Name

*

First Name

Last Name

Service Member Social Security Number (LAST 4 ONLY)

*

Email

*

Verify Email

*

Physical Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Mailing Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Home Phone

Cell Phone

Marital Status

*

Maiden Name

Other Legal Names You Have Gone By

I.e. Enter former last names if multiple marriages or name changes.

Birth Date

*

(mm/dd/yyyy)

Age

*

Gender

*

Number of Children

*

Campaign

*

Check all that apply.

OEF

OIF

OND

Current or Final Rank

*

Unit Deployed With

*

Date(s) of Deployment

*

Currently Active Duty?

*

VA or Unit Contact Name

*

VA or Unit Phone

*

Description of injuries or illness

*

Total Amount of Funds or Assistance Needed

*

Please enter the total amount needed to resolve the issues.

Amount of Funds or Assistance Request from Operation Ward 57

*

Please enter the total amount requested from Operation Ward 57 for this grant request. Funds requested may not equal the total financial need.

Detailed description of why you are requesting the funds

*

Please give a detailed description of why you are requesting the funds. For example, What is the cause of your hardship? Future plans to avoid the same hardship?

Other foundations that have been notified or have received assistance from for this request/need

Include award/grant amounts and date of award.

Name of Case Manager

*

First Name

Last Name

Relationship to Service Member

*

Example: VA Case Worker, AW2 Rep, Another Nonprofit Case Manager, etc

Case Manager Phone

*

Case Manager Email

Verify Email

Disclaimer: On my behalf and on behalf of my dependents, I fully and forever release, discharge and hold harmless Operation Ward 57 and its directors, officers, and advisors of and from any and all claims, demands, actions, causes of action, suits, controversies, and liabilities of every kind and nature accruing to me or my dependents arising directly or indirectly from, or on account of the activities and assistance of Operation Ward 57.

I agree to Disclaimer

*

I Agree

I authorize Operation Ward 57 to verify all information in this application, including SSN for the purpose of verifying identity.

I agree to Verification

*

I Agree

I authorize Operation Ward 57 to contact those in this application for the purpose of verifying identity, discussing my case and general care or treatment inlcuding mental health and substance use diagnosis. I understand I may be asked to complete a seperate Release of Information.

I agree to ROI

*

I Agree

I agree all information contained in this application is accurate and honest as of the date above:

*

I Agree

Name of Person Completing Form

*

First Name

Last Name

File Uploads

Additional Documentation Required

Before an application can be considered and action can be taken by Operation Ward 57, we will need this application and a copy of the following documents uploaded, mailed or emailed back to our office at Operation Ward 57, PO Box 80055, Seattle, WA 98108 or grants@operationward57.org. Files are uploaded to a secure wesbite.

If Service Member is retired:
1) A copy of the Service Member’s DD214 showing honorable discharge (Service 2 or 4 Copy Only).
2) A copy of the Service Member’s VA Letter of Determination (Must be 60% or higher)

If the Service Member is Active Duty:
1) A copy of the service member’s most current LES

2) Letter from Command/Doctor listing disabilities or other documents showing disability

*Additional Items May be Requested such as copies of bills, bank statements, tax returns, phone bills, etc.*

Refusal to provide documents may result in denial of your application.

Operation Ward 57 will only retain copies of requested documentation for up to 12 months.

DD214

VA Rating Letter