Application

Applicant Information

First name

Last name

Phone

Affiliation (Military, First Responder, Civilian, etc.)

Are you applying for yourself, or nominating someone else?

If nominating: Relationship to nominee

Do you have any animals in your household? If yes, please describe.

Tell us your story.

What does loyalty mean to you? How have you demonstrated it in your life or career?

What challenges are you facing that you hope this support will help with?

How does your experience align with the mission of Lotz of Loyalty?

Have you benefited from or worked with a service or support animal?

What would receiving this support mean to you or your family?

If selected, how will you use the resources provided by Lotz of Loyalty?

How do you plan to give back or pay it forward in your community?

Upload any documentation that supports your application (e.g., DD214, letters of recommendation, photos, medical records, etc.)

One or two people who can speak to your character or story.

Person One

Full Name

E-Mail Address

Phone

Person Two

Full Name

E-Mail Address

Phone