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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
Acadia
Allen
Ascension
Assumption
Avoyelles
Beauregard
Bienville
Bossier
Caddo
Calcasieu
Caldwell
Cameron
Catahoula
Claiborne
Concordia
De Soto
East Baton Rouge
East Carroll
East Feliciana
Evangeline
Franklin
Grant
Iberia
Iberville
Jackson
Jefferson
Jefferson Davis
La Salle
Lafayette
Lafourche
Lincoln
Livingston
Madison
Morehouse
Natchitoches
Orleans
Ouachita
Plaquemines
Pointe Coupee
Rapides
Red River
Richland
Sabine
St. Bernard
St. Charles
St. Helena
St. James
St. John The Baptist
St. Landry
St. Martin
St. Mary
St. Tammany
Tangipahoa
Tensas
Terrebonne
Union
Vermilion
Vernon
Washington
Webster
West Baton Rouge
West Carroll
West Feliciana
Winn
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