Application — The Veterans Club Connect

Application

We we provide a 33% discount for North Idaho veterans. to be applied when accessing the Mission Resilience course.

To apply for the discount, please complete the form below, save it as a PDF, and email the form to the Review Board at The Veterans Club. If notified of acceptance, you will be
emailed a discount code for you to use on the Mission Resilience website.

Fill this form, then click Print / Save as PDF.

Applicant Information

Full Name*
Date of Birth

Email*
Phone*

Home Address*

Military Service

Branch of Service*

Rank / Pay Grade*
Discharge Status*

Dates of Service — Start*
Dates of Service — End*

Request Type

Vet Club Discount
Reserved

Course Purchase Date*
Amount Paid (USD)*
Payment Method

I will attach proof of payment.

Certification & Signature

I certify that the information provided is true and correct. I authorize The Veterans Club Connect (and partners) to verify my veteran status and to use the information provided solely for administering assistance for the Mission Resilience course.

Typed Signature (Full Name)*
Date*

Draw Signature (optional)

Tip: In the print dialog, choose Save as PDF to create a digital copy.

Email Scholarship Team

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