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Veteran Program – Participant Registration

Thank you for applying to the Higher Ground Veteran Program. We strive to ask only the questions we need to best serve you. If you have questions, would like assistance, or prefer to apply over the phone contact…

  • Higher Ground Sun Valley: Dave: dave@highergroundusa.org or call 208-721-8064.

  • California Residents: Kris: kris@highergroundusa.org or call 213-761-5393

  • New York Residents: Natasha: natasha@highergroundusa.org or call 716-984-7806

Basic Information

Mailing Address

Include Apartment # and multiple lines of addresses (if necessary)

Physical Address

Include Apartment # and multiple lines of addresses (if necessary)

Contact Information

Demographics

Do you think of yourself as (please select one).

Please select one or more of the following which you feel
best describes you. (Hold CTRL + click to select multiple.)

Do you think of yourself as (please select one).

Which of the following categories best describes your situation in the last 6 months? Please select all that apply. (Hold CTRL + click to select multiple.)

Military Information

Where did you deploy, or what operations did you support? (Check all that apply)

Medical & Recreation
Do you have symptoms of any of the following? 

Hidden Fields

DD Form 214
In addition to this application, we require all potential participants to provide a copy of their most recent Certificate of Release or Discharge from Active Duty; more commonly referred to as your DD FORM 214. When you were discharged from the Service you should have received two copies of the DD FORM 214 – a short form and a long form. The long form includes the type of separation (block 23), character of service (block 24), separation code (block 26), reentry code (block 27), and a narrative reason for separation (block29). In the lower left hand corner of the long form you should see DD FORM 214 and in lower right hand corner you should see Member–4. This is the copy that we are asking you to send us.

You can submit the DD FORM 214 at a later date, however you must send it to us prior to participating in Higher Ground Veteran Programs.