Apply

To be considered for the program please fill out the form below.

First Name

Last Name

Phone

Address

City

State

Zip Code

Military Branch and Unit deployed with when the injury/trauma occurred.

Please write a brief description of when, where, & how the injury/trauma occurred, how your injury affects your daily life, and how receiving a tablet would benefit you.

Please confirm that you are currently a veteran and no longer active duty.

How did you hear about iWarriors.org Tablet program?

Uploading your DD214 is required (with SSN redacted); though please also provide any additional documentation related to your injury.

I consent to the use of my name, last initial, general story as provided above or in a testimonial, and/or a picture I provide to iWarriors for informational purposes to be shared with our donors and/or prospective donors in print, digital, and/or social media.

I Consent