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VETERAN RETREAT APPLICATION
Application
CAMP KUM BA YA
Veteran Retreat Date (Only available retreats are listed)
*
First name
*
Last name
*
Application Date
*
Last 4 of Social Security Number
*
Phone
*
Email
*
Address Line 1
*
Address Line 2
City
*
State
*
ZIP Code
*
When and Where did you serve?
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Tell us about you and why you want to attend our retreat
*
Do you have a service animal?
*
Will your service animal attend?
*
Do you require special accommodations? (including food allergies)
*
If yes, please describe the accommodations required. If no, write "N/A"
*
Have you attended our retreats in the past?
*
Do you require transportation? (Currently, funding is limited and we provide transportation on a case-by-case basis)
*
Submit
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