Request Help Form

SEAL/SWCC/NSW/SOF Parent Information

Thank you for visiting our REQUEST FOR HELP page. Please complete the form in its entirety in one submission. You must complete this form as a first step to be considered for support. As always, our Program Specialist is here to help, if you have questions, please email Alma Fowler, afowler@sealkids.org.

 

Questions about applying for services or grant eligibility? Consult our FAQ for more information.

 

Request Help Form

ALL FIELDS REQUIRED


Legal First Name of SEAL/SWCC/NSW/SOF Parent:
Legal Last Name of SEAL/SWCC/NSW/SOF Parent:
Email of SEAL/SWCC/NSW/SOF Parent ACTIVE DUTY PLEASE USE SOCOM EMAIL ONLY (Veteran - personal email OK)
SEAL/SWCC/NSW/SOF Parent Relationship to Child:
Military Status:

Additional Contact Information


If you are the SEAL/SWCC/NSW/SOF person listed above, please provide an additional email address and alternate contact person. YOU MUST GIVE AN ALTERNATE CONTACT OR YOUR APPLICATION WILL NOT PROCESS (e.g. other parent, guardian, grandparent, etc.) PLEASE DO NOT USE SEAL/SWCC/NSW INFO as additional contact information. The Additional Contact Email address is the primary contact email address. After submission, please check this email for further instructions. Please ensure this email address is typed correctly.

Additional Contact/Spouse First Name:
Additional Contact/Spouse Last Name:
Additional Contact/Spouse Email:
Additional Contact/Spouse Relationship to Child:

Your Child's Information


Legal First Name of Child:
Legal Last Name of Child:
Gender of Child:
Birthdate of Child (DD/MM/YYYY):
Grade at start of Fall school year:
What State does your Child reside in?
For OTHER, where does your Child reside?
Zip/Postal Code where Child lives:
Has this Child received SEALKIDS services before?:

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