Volunteer Mentor Corps Application

FULL NAME: _______________________________ Date: _____________

ADDRESS:  ____________________________________________________  _____________________________________________________________

EMAIL ADDRESS: ______________________________________________

PHONE NUMBER 1 __________________HOME (    ) WORK (    ) CELL (    )

PHONE NUMBER 2 __________________HOME (    ) WORK (    ) CELL (    )

BRANCH OF SERVICE: _________ LENGTH OF SERVICE: ____________

MOS / RATING TYPE OF DISCHARGE: ____________________________

NAME AND LOCATION OF COMMANDS: ___________________________ ______________________________________________________________

DEPLOYMENTS: _______________________________________________ ______________________________________________________________ ______________________________________________________________

CURRENT OCCUPATION AND EMPLOYER: _________________________ ______________________________________________________________ ______________________________________________________________

Signature:_____________________________________________________

A copy of your DD214 is required – please remit with this application

VETERANS COURT MEETS EVERY TUESDAY, 1:30 P.M. FOLEY SATELLITE COURTHOUSE with  DISTRICT COURT JUDGE MICHELLE THOMASON. WE RECOMMEND YOU APPEAR AT 1:00 P.M. TO MEET WITH THE VETERAN PARTICIPANTS.