Helping Our Heroes

  • MM slash DD slash YYYY
  • This is just a check list of the items needed for eligibility.
  • You may take a pictures with your phone and upload those images here.
    Drop files here or
    Accepted file types: jpg, png, gif, pdf, Max. file size: 50 MB.

    • Discharge must be honorable/General/General under Honorable Conditions

    • (i.e. copies of bills, estimates for car repair, dental work, receipts for clothing to purchase, etc.)
      Drop files here or
      Accepted file types: jpg, png, gif, pdf, Max. file size: 50 MB.

      • Assistance Requested:

      • Veteran must provide mortgage agreement, rental agreement, eviction notice, or looking for housing.
      • Veteran must have disconnect/final notice in Veteran's name.
      • Not to be used for alcohol, tobacco or lottery products.
      • Bus pass or gasoline if needed; for gas, must have valid license, registration, insurance, in Veteran's name.
      • Must be doctor-ordered medication in Veteran's name.
      • Copy of death certificate and quote from funeral home.
      • Assistance necessary to become or remain employed.
      • Necessary for employment/medical. Must have license, registration, and insurance, in Veteran's name.
      • Emergency dental treatment as recommended by the Free Clinic of SW Washington.
      • To prevent auction and loss of items, must have final notice.
      • Must show need for assistance.
      • Must show enrollment in college, university or approved trade school in Washington State.

      • *PLEASE SEE POLICIES AND PROCEDURES FOR ALL REQUIRED ELIGIBILITY DOCUMENTATION.

      • Veteran's Certification

        I have no assets or other resources to meet the needs identified above. I have been a resident of Washington State for at least one year and live in Clark County. I certify that the information I have provided is complete and accurate. I understand that I may be subject to criminal prosecution if I have knowingly provided false information.

        I give my permission for this agency to request/release information necessary to receive benefits from this request. I further give my utility vendor and landlord permission to release my account information to the agency. I understand assistance is in the form of vouchers or direct payments to vendors.

      • I have no assets or other resources to meet the needs identified above. I have been a resident of Washington State for at least one year and live in Clark County. I certify that the information I have provided is complete and accurate. I understand that I may be subject to criminal prosecution if I have knowingly provided false information.


        I give my permission for this agency to request/release information necessary to receive benefits from this request. I further give my utility vendor and landlord permission to release my account information to the agency. I understand assistance is in the form of vouchers or direct payments to vendors.

      • I give my permission for this agency to request/release information necessary to receive benefits from this request. I further give my utility vendor and landlord/mortgage holder permission to release my account information to the agency. I understand assistance is in the form of voucher or direct payment by mail to vendor.
      • MM slash DD slash YYYY

      • Affidavit

      • I, attest that I will not use my Winco/Chevron gift card for any other purpose, but to purchase food, personal hygiene items, toiletries, baby items, pet food and fuel.

        Food/Gas vouchers may not be used for alcohol, tobacco, or lottery products.

      • MM slash DD slash YYYY
      • This field is for validation purposes and should be left unchanged.

      Located in Downtown Vancouver WA

      Serving Veterans in the Clark County:
      Vancouver WA | Camas | Washougal | Ridgefield | Woodland | La Center | Longview | Portland OR

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