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Disabled Veterans Program

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DISABLED VETERAN PROGRAM ENTRY FORM

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Do you want to use an Alias or Anonymous name for our winners drawing?*

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Dog's Breed*

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Task dog is trained to perform to mitigate their medical condition (Do not confuse this with the medical condition itself).*

Please provide a copy of your DD214 form or your Military ID Card*

Disabled Veterans must provide either their DD214 form or Military ID Card to qualify for the program.

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OUR LOCATION

Winston-Salem, NC 27127

Phone: 518-955-1869

Email: info@pupcessoriescrafts.com

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