NOMINEE

NOMINEE/BENEFICIARY

CONSENT TO EXCHANGE INFORMATION

I UNDERSTAND THAT ADDITIONAL INFORMATION MAY BE REQUIRED TO ADEQUATELY VERIFY ELIGIBILITY FOR A GRANT. BY SIGNING THIS FORM, I AM ALLOWING A REPRESENTATIVE OF RAISING RAIDERS TO COMMUNICATE WITH THE CONTACT OF THE ORGANIZATION AND/OR THE CONTACT PROVIDED ON THE MILITARY ORDERS. I CERTIFY ALL THE INFORMATION I HAVE SUPPLIED IS TRUE AND CORRECT. I PERMIT RAISING RAIDERS STAFF TO VERIFY THE INFORMATION ON THIS APPLICATION.

Virtual Signature *

By typing your name into the fields below , you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application and