US Bank Helping Hands for Hometown Heros Application Form

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Operation Helping Hands for Hometown Heroes ***Form due back to Christina Rost (Christina.r.rost.ctr@mail.mil) NLT 10 Nov*** US Bank would like to sponsor Minnesota military families this holiday season. Please have the family complete this form in full. This is a “wish list” that will be provided to the sponsoring USB team. Where is your nearest Military Family Assistance Center (FAC)? Bemidji Brooklyn Park Camp Ripley Detroit Lakes Dultuth What is the nearest large town/city to you?

Mankato

Marshall

Rosemount

Please tell your USB team a little bit about your family

What branch of service does your family’s Service Member represent? Army Navy Marine Corps Air Force Coast Guard ACTIVE DUTY NATIONAL GUARD OTHER RESERVE COMPONENT Is your family’s Service Member an currently deployed?

Yes

No

What are       your general family needs? SM’s First Name: Age:

WISH LIST:

Gender:

Male Female

Dep #1 First Name:

Age:

WISH LIST:

Male Age:

Gender:

Male Age:

Gender:

Female WISH LIST:

Dep #3 First Name:

Dep #2 First Name:

Gender:

Male Female

Dep #4 First Name:

Female WISH LIST:

Dep #5 First Name:

Male Age:

Gender:

Male Age:

Female

Gender: Female


WISH LIST:

WISH LIST:

THIS SECTION FOR MILITARY FAMILY ASSISTANCE ONLY Family # Assigned by FAC and any details for USB:


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