Veteran Leadership Course Registration

For more information, please visit our website at https://vantagepointfoundation.org/.

Your Contact Information

First Name *

Last Name *

Email *

Address Line 1 *

Address Line 2

Phone

City *

State *

State/Province

Zip *

Postal Code

Country / Region

Emergency Contact *

Emergency Contact Phone *

Emergency Contact Email

Did you serve post-9/11 (September 11, 2001)? * The field Did you serve post-9/11 (September 11, 2001)? is required.

Do you have an honorable discharge? * The field Do you have an honorable discharge? is required.

(If active) Do you have an established end of service date?

Date Entered Service * The date field Date Entered Service is required.

End of Active Duty Service * The date field End of Active Duty Service is required.

Branch of Service * The field Branch of Service is required.

VA Disability Rating % (If Applicable) * The numeric field VA Disability Rating % (If Applicable) is required.

DOD Disability Rating % (If Applicable) * The numeric field DOD Disability Rating % (If Applicable) is required.

Employment Status * The field Employment Status is required.

Gender * The field Gender is required.

Race/Ethnicity * The field Race/Ethnicity is required.

What do you want from this program? * The field What do you want from this program? is required.

What are your goals? * The field What are your goals? is required.

I am willing to do personal growth work * The field I am willing to do personal growth work is required.

I’m aware this course may include both male and female participants and I’m able to fully participate.

Preferred Course Dates * The field Preferred Course Dates is required.

Please Note any Food Restrictions or Allergies: * The field Please Note any Food Restrictions or Allergies: is required.

T-Shirt Size: * The field T-Shirt Size: is required.

Would you need early arrival (night before)? * The field Would you need early arrival (night before)? is required.

Do you need a handicap accessible room? * The field Do you need a handicap accessible room? is required.

How did you hear about Vantage Point Foundation * The field How did you hear about Vantage Point Foundation is required.