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Are you a member of a federally recognized tribe, a Native Hawaiian, or a Native Alaskan? Or in the State of Louisiana, are you a member of The United Houma Nation?
Yes
No
Are you a veteran?
Yes
No
If yes, are you currently in the active military or have you been discharged under conditions other than dishonorable?
Yes
No
Are you the spouse of a veteran?
Yes
No
If yes, is the service member missing in action, captured, or forcibly detained for at least 90 days or does the veteran have total service-connected disability, per VA evaluation?
Yes
No
In what County/Parish do you live?
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Non-Service Area
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