Your Name (person submitting the EAF) *

First Name

Last Name

Your Phone Number *

Phone # that you receive text messages at

(###)

###

####

Member's Name *

First Name

Last Name

Did you independently verify the need? *

Did you personally verify the event/need through the CO, XO, CMC or through direct knowledge of the event?

Yes

No

Member's Address *

If Navy Federal is not an option, a check can be mailed to this address. It's also important that we capture what State the aid is received in.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country