NH Patriot Guard Riders

Help On The HomeFront (HOTH)

 NH Patriot Guard Riders

Help on the HomeFront

 

It is the intention of the New Hampshire Patriot Guard Riders (NHPGR) to assist the military veteran community by taking a proactive role in the reintegration of our wounded Veterans into the society they have committed to protect and defend. This directive is set out by the Patriot Guard National Board as well as the NHPGR to augment the PGR mission as it is written.  

The NHPGR wishes to serve all of our heroes, not only those who have paid the ultimate price, but also their families, and those veterans whose lives have been dramatically and forever changed by their service to the United States of America.

The physical condition of some of these Veterans often creates overwhelming and seemingly insurmountable challenges as they struggle to adapt to them.  Often, they will have to relearn the very things that gave them a sense of personal pride in their accomplishments.  They may have to find acceptance of their current condition and where it may lead.  This can be eased somewhat with a sharing of the knowledge and skills that many of our members have already gained through their life experiences. For many, life will never be the same.  It is the HOTH vision to help secure a place in our communities so our Veterans will continue to be treated with the dignity and respect they have earned and deserve.  They are true American Heroes who face many challenges on the way to overcoming their disabilities.  They are our brothers and sisters in arms, friends, family members and neighbors.  The HOTH program personnel consider it a privilege to be assisting Veterans in need.

HOTH personnel will attempt to visit and assist these Veterans as they recover and heal.  HOTH personnel will endeavor to assist the returning service members as they readjust to life after periods of medical care.  HOTH will, within reason, commit to the Veterans and their needs as long as practicable.

Below are the national PGR and the New Hampshire state goals of the HOTH program.

NATIONAL GOALS:

  • Establish a strong presence and mentoring program on Brooke Army Medical Center, Walter Reed Army Medical Center and Bethesda Naval Hospital, other major medical facilities and overseas if possible.
  • Work diligently towards the recommendations set forth by medical personnel regarding our involvement with wounded Veterans. 
  • Establish a support network for catastrophically wounded Veterans who are reentering their communities. This may be a continuation of the inpatient program.
  • To develop a National plan to be carried out on the state level for an active and frequent PGR presence in all of the VA hospitals wherever they may be. 
  • Visitation of Military retirement homes and villages. 
  • Appoint a state HOTH Coordinator that can coordinate between the state and National levels.

 NEW HAMPSHIRE STATE GOALS

  1. Support all National goals.
  2. Work with local community support groups to assist our veterans in local communities, throughout the State of New Hampshire.

The above goals form the foundation of the New Hampshire state HOTH program. The New Hampshire HOTH program will not detract from the New Hampshire PGR’s primary mission of honoring those service members who have fallen.  Nor, will HOTH programs overshadow or infringe upon any existing civilian community support programs.  HOTH will within reason, do all it can to support any worthwhile endeavor that enhances the lives of our wounded Veterans, and maintains the PGR/NHPGR mission of honoring fallen heroes.  The good will of the other active Veterans’ organizations is highly valued and greatly appreciated.  The HOTH program will cultivate and build upon the contributions of other active Veterans organizations, where their goals and HOTH goals are synchronized.  Additionally, the HOTH mission will enable any PGR member who is unable to participate in honor missions (due to work commitments, financial reasons, or family duty) an opportunity to support this program.  It is only with the support of PGR state members, state and federal government coordination efforts and the mutual support of other organizations, that the NHPGR HOTH program can be a success.

HOTH- WHAT IT IS AND WHAT IT IS INTENDED TO DO

HOTH originated from formal requests of PGR Members to the National Board of Directors (BoD) to support our wounded servicemen.  A poll was posted on the PGR site asking if this was something that the membership at large wanted the PGR to do. The response was a resounding and overwhelming “Yes.”

HOTH has undergone many changes in personnel, and personality since its inception.  It has a personality based on those involved, and projects a true passion for helping our heroes and their families.

The New Hampshire PGR will do its utmost to be fair and consistent in handling all requests received.  The following procedures are to be implemented effective immediately.   

  • All HOTH requests will be directed to the State Captain (SC), Deputy State Captain (DSC) or the HOTH State Coordinator. 
  • If a request is received at the National PGR level, it will directed to the SC or his designated representative for initial processing. 
  • Response to these requests will be acted upon by the NHPGR leadership as quickly and efficiently as possible.  All those submitting requests need to understand that the PGR is an all volunteer organization and as such, some requests may take more time than others dependent upon the complexity of the request and availability of key personnel. 
  • If a HOTH candidate feels that excessive time has elapsed without an NHPGR response, or the request may be complex with unforeseen variables, the requester is encouraged to personally contact the SC, DSC or the State HOTH Coordinator to assist in processing the assistance request. 
  • An incarcerated veteran will not be eligible for help while he/she is incarcerated.  The Veteran’s immediate family (spouse and children) may be eligible, based on demonstrated needs. 
  • The problems faced by Veterans are numerous and varied.  The NHPGR will be careful with these challenges. The NHPGR will not get involved in taking sides on legal issues. 
  • The NHPGR HOTH program was not intended to provide long term support to Veterans or their families.   The HOTH program is meant to provide a short term supplement to existing formalized support programs already in place. If long term assistance, or resources that exceed the PGR’s limited capability are requested, they will be denied.  The HOTH lead representative to the affected family will try to procure resources from existing agencies or organizations equipped to deal with these circumstances.

NEW HAMPSHIRE HOTH IS A TWO PART PROGRAM:

The first part is to provide a formalized program for PGR members to be authorized to enter major military critical care hospitals and Veterans homes to visit with our wounded and aging soldiers.  How that is organized, what activities happen, and how extensive it is will be managed by the person empowered by the HOTH state Coordinator.  HOTH support is volunteer and contingent upon many variables (desires of the Veteran, needs of the Veteran, number and proximity of volunteers who can provide appropriate support) so each instance of help will handled on an individual basis. 

  1. The second part of the program is to provide a framework so that when a soldier is finally discharged and goes home, there will be a NHPGR presence to continue the relationship that was established at the medical center.

Throughout the State of New Hampshire, we hope there will be a concerted effort by HOTH teams and the NHPGR to let these fine young Americans and Heroes from any current or previous wars know they are appreciated and wanted.  It is the HOTH vision and goal to have HOTH teams identified throughout the state to assist veterans and their families once a need is verified and validated.

The service personnel that are the most critically wounded will most likely have had their lives forever altered by their wounds or loss of limbs.  Some of them will never have what they themselves consider to be a normal life again.  While they were at a major medical facility, they received excellent care and support.  All of their paperwork was done for them.  When they go home, the world that they once knew has been altered and they no longer have the support infrastructure of the military to support and assist them.

The NHPGR HOTH may be able to and will attempt to provide some of that support during the critical transition period from the military back to a civilian lifestyle.  The NHPGR members that wish to help these young men and women will find HOTH an avenue for them to provide help and comfort to these veterans.  The NHPGR members could be doing things like connecting veterans to existing support organizations such as the American Legion and the Veterans of Foreign Wars.

The PGR as a state organization does not have a way of knowing what help may be required.  Each situation will be unique and must be treated as such.  Each of these young men or women we will be working with has unique circumstances and challenges.

WHAT HOTH IS NOT

HOTH is not a separate organization within the PGR.  There are two levels of activities within HOTH, National and State.  The New Hampshire State HOTH Coordinator is a volunteer selected and approved by the State Captain, and deemed to have the necessary skills to execute and manage the program efficiently and effectively.  The HOTH Coordinator may not be part of the NHPGR Leadership but enjoys special access to the Leadership and fulfills an important and critical position within the New Hampshire State organization.

The mission of the Patriot Guard Riders has always been, and will continue to be honoring our fallen heroes.  HOTH is a secondary or complimentary mission.  If the two missions come in conflict, our primary mission will be prioritized accordingly.  The State Captain or Deputy State Captain will resolve any situations that require clarification and ensure PGR activities are correctly prioritized.

OTHER ACTIVITIES – UNDER HOTH

The National PGR is assumed to support New Hampshire’s HOTH missions.  Those activities deemed worthy of NHPGR support can be expected to be posted as necessary in the state’s PGR forum.  The National PGR will not dictate what New Hampshire’s HOTH activities will consist of or how they are executed.

This is New Hampshire’s HOTH program.  If the membership of NHPGR wishes to formally coordinate with other organizations for support activities and assistance to a HOTH mission that will be acceptable.  PGR representatives must solicit approval from the HOTH State Coordinator.  The SC, DSC or HOTH Coordinator will ensure that the State HOTH program is always synchronized with the National PGR HOTH program.

HELP ON THE HOME FRONT (HOTH)

The following is intended as a guide only.  Some points may be flexible based on the situation, and with concurrence of the State HOTH Coordinator and the State SC or DSC.  The following guidelines are published so our members can more clearly understand what HOTH is and how it is intended to function.

STATE HOTH COORDINATOR AND HOMEFRONT VOLUNTEERS (HFV)

Operational Guidelines

The State HOTH Coordinator is responsible for coordinating HFV efforts at the state and at local levels.  The HOTH Coordinator will work closely in coordination with New Hampshire HFV’s.

This appointed individual will be allowed to delegate responsibilities as needed and will work closely with the State Captain, or Deputy State Captain to achieve maximum impact and support for the wounded Veteran.  It is recommended that the State HOTH Coordinator consider being a member of the Veteran Administration Volunteer Services (VAVS) committee at the VA medical center nearest them.

It is a directive of the National Board of the PGR that good will and mutual participation be maintained with all other area Veterans’ service organizations. Coordination is recommended with these area organizations to achieve maximum support of Veterans in the area, without infringing upon the efforts of these organizations.  Invitations of support are to be considered an honor and will be supported with vigor and enthusiasm whenever possible.  As we may share members between our organizations, it is recommended that these members be consulted for planning purposes.

The mutual and primary objective is the support and care of our Veterans.  The Veteran will always be our main focus.   This is our common bond.  Volunteering in support of programs such as the Friendly Visitor Program at VA hospitals and many others can be most rewarding.

THE STATE HOTH COORDINATOR WILL:

  • Manage, at the state level the NHPGR Help on the Home Front program.
  • Communicate with the State Captain and the Deputy State Captain on volunteer support, dates, times and level of service provided.
  • Establish long-term relationships between the PGR and Veterans to support the quality of life needs of the Veteran and the family.
  • Create reference material, or resource lists for each particular area and/or region, to allow for quick reference when needed. These resource materials will be made available to persons in need of support for their reference.

PGR MEMBERS

The New Hampshire members of the PGR are passionate about the missions for a variety of personal reasons.  There are those who are committed, but emotionally cannot stand with us on a mission.  There are family members of our fallen heroes, our Gold Star mothers and fathers, who cannot attend a mission because it is too painful for them.  HOTH may be a perfect fit for these members.

HOTH activities can be conducted at anytime. These activities are a great way for those who want to do something, but can’t participate in missions for various reasons.  HOTH must not be construed as an additional burden on our riders who attend missions.  HOTH is a way for those members who want to help but can’t in other ways, be able to do something that is not only rewarding for them, but will have a positive impact on the lives of our wounded soldiers.

CRITERIA FOR FUNDING REQUESTS

At least 3 of these conditions listed directly below must be met. 

  1. Support of an active duty service personnel. 
  2. Support of active duty personnel’s family, in an emergency situation. 
  3. Support of wounded and or disabled Veterans in verified need of support. 
  4. Veterans, or service members must show, or have verified, that they are doing all they can to help themselves out of the financial crisis or negative situation. 
  5. Immediate family members of Veterans or service members are defined as: –Spouse and children and will not normally include parents, sisters, brothers etc. (subject to review and may be appealed thru the State HOTH Coordinator, if necessary).
  6. Service personnel deployed or in a position that they cannot contribute to the solution. 
  7. Verification of circumstances by the State Captain, Deputy State Captain, State HOTH Coordinator, or a State HOTH Coordinator appointed representative. 
  8. Veteran or service member is receiving support in a medical care facility

WHAT WILL NOT BE COVERED BY HOTH

  • Items purchased from the PGR store. 
  • Food for volunteers. 
  • Travel costs unless approved in advance. 
  • Purchase of alcoholic beverages. 
  • Items that could cause harm to volunteers or other persons. 
  • Legal fees for incarcerated Veterans and or family members. 
  • Funds for extended relief if the subject of the request is not showing efforts to change his situation or financial problems. 
  • Repeated meals for the same Veteran. (Costs per person’s support will be tracked by the HOTH coordinator, or appointed representative and reviewed each time a request is made) 
  • Support for any individual should not exceed $200.00 without SC or DSC approval.  All requests to exceed this amount will require justification of the HOTH Coordinator and approval of the SC/DSC. 
  • All requestors are reminded that neither the NHPGR nor HOTH are designed to function as a debt relief organization. Requests for Soldiers or Veterans for funding related to personal finances will not be considered.

 WHAT HOTH WILL COVER AS LEGITIMATE EXPENSES

  • Meal cost per person will be compatible with per diem tables available from the IRS, (no meal should exceed $100.00, and this amount must be justified). 
  • Personal Care items, needed, (hygiene articles).
  • Emergency clothing replacement, (NOT wardrobes) e.g. underwear, t-shirts, socks, pants. 
  • Special events for major facilities, planned, itemized, and documentation provided before and after the event. 
  • Phone cards up to $20.00. 
  • Emergency travel assistance, within financial capabilities of the NHPGR resources and approved by the SC as funding permits. 
  • Mileage reimbursement for emergency assistance in transportation of family members when no other means is available (Subject to review and IRS rates). 
  • Support of Veterans Administration Medical Center (VAMC), holiday ward support, these requests usually come from the Veterans Administration Voluntary Service (VAVS) committee at the VAMC. These may average $50.00-$75.00 depending on the holiday. 
  • Special requests with approval at the level of request, i.e. State or National.

THINGS REQUESTORS SHOULD CONSIDER PRIOR TO ASKING FOR FUNDS

  • Seek help from friends, family and PGR members in our state or adjoining states. 
  • Seek help from the destination state if travel is involved.
  • The HOTH coordinator will build, develop, maintain and share a reference list of resources available in New Hampshire that help Veterans/Families.
  • The HOTH coordinator will strive to maintain a list of state and federal resources available that NH veterans or their family members may be able to contact for assistance.
  • Expect the HOTH coordinator to evaluate and determine if this is a repeated request.  The NHPGR will strive to avoid repeat requests to support any one family over a period of time unless approved by the SC or DSC.
  • The Requestor is expected to fill out the request form, forward it to the New Hampshire State HOTH Coordinator.  The HOTH Coordinator will then notify the SC or DSC of the pending request.
  • In disability issues, we are not Veteran Service Officers (VSO’s) and will not be expected to act in that capacity.
  • If asking for funds in advance, the requestor should provide as detailed of a list as possible outlining the intent and purpose of the requested funds.  All requestors will be expected to provide original receipts to the State HOTH Coordinator to verify purchases and amounts.  Any and all excess funds will be returned to the PGR with the purchase receipts.
  • Remember that transportation costs are multi-faceted, and can go to and from hotels, meals, transportation, to and from the airport.  Requestors are asked to try and estimate the true costs so accurate forecasts can be developed and planned for.
  • A request starts within the state in which the recipient lives, whenever possible.

RECORD KEEPING:

The State HOTH Director maintains a compete and accurate database of requests that funnel through the HOTH office.  In this record keeping, the State HOTH Coordinator should record the following items for any HOTH expenses, and to eliminate repeated requests, or unfairly using NHPGR’s limited resources.

SUPPORTING DOCUMENTS

Organize transactions such as contributions, purchases, sales, and payroll will generate supporting documents.  These documents: grant applications and awards, sales slips, paid bills, invoices, receipts, deposit slips, and canceled checks contain information to be accurately recorded in accounting records.  It is absolutely imperative and required by law to retain these documents.

Expenses are the costs a public charity incurs (other than purchases) to carry on its program.  Supporting documents should show the amount paid and the purpose of the expense.

Documents for expenses include (but not limited to):

  • canceled checks (copies),
  • cash register tapes,
  • contracts,
  • account statements,
  • credit card sales slips,
  • invoices, and
  • petty-cash slips for small cash payments.  

The following requested information, is a guideline to ensure funding requests are handled in a timely manner:

  • Who- is requesting help
  • What- is it they need
  • When- do they need it
  • Where- should it go
  • How- did you find out about it, and do you know how to address the request?
  • Contacts- anyone you talk to or request anything from.  Keep phone numbers, names, commands, emails, etc.
  • Meal costs for Service members should be in line with the IRS Per Diem rates; this table is available via the internet.

HOTH National funding may be a secondary source for New Hampshire State funding requests.  Until National HOTH is fully funded, via donations and or sponsors, State HOTHS are being asked to seek other means first.  Disability issues need to be directed to a VSO and or advocates, the same with Social Security filings.  Make sure the disabled Vet or families know these factors.  The HOTH coordinator will always let the family take the lead and ask questions.  HOTH personnel will strive to help the service member, Veteran or family member with finding the correct answer to any question.  NHPGR HOTH will work with other Veteran organizations to see if they have a program and or funding available.  Then, in turn support that organization when requested.

National PGR HOTH reminds all state PGRs of the following:

  • Each state should be pursuing funding HOTH for its state.
  • The National Director is responsible for administration of these funds, via approval of the SC/DSC.
  • Whenever appropriate the SC, DSC, RC’s, or State HOTH Coordinator should try to find sponsorship for HOTH at the state and or National level.

HOTH is the basis of us being a 501.c.3 organization.  If National PGR cannot meet the criteria set forth by the IRS and state regulations, we will not be a respectable and legitimate 501.c.3.  In the eyes of some sponsoring organizations and persons we would not eligible for their funding.

There is a database online for tracking the status of 501.c.3’s.  Each state lists and maintains a status on charitable organizations. 

Below are some reference points.  The IRS maintains a list accordingly.

http://www.charitywatch.org/toprated.html

WHEN AND IF ANYTHING SHOULD BE POSTED IN HOTH EVENTS

If non-confirmed information is posted, the post will be subject to editing or removal.  The New Hampshire State HOTH coordinator will ensure to provide all information to the SC or DSC for approval prior to posting.  

PGR HOTH MISSION CRITERIA FOLLOW:

  • A PGR initiated event (if it supports the funding criteria) could be a HOTH event.  Merely being invited to attend an event being organized by another group does not guarantee the event supporting funds or posting under HOTH forums.
  • In order to protect the privacy of our heroes and their families, the State HOTH Coordinator or State Captain will not post their email address, mailing addresses or other contact information in these forums.  This is a public forum viewable by many different agencies and other organizations.  All addresses should be exchanged via email or private message.  If you wish to receive the address of the person to whom mail should be sent, please contact the originator of the thread by clicking email or Message below their name next to the post to obtain the necessary information or contact the State HOTH Coordinator who can determine Veteran’s desire for contact.
  • If you are positive the Hero or family would want their contact information posted, it is required that a release form be signed and delivered to the HOTH Coordinator.  Publishing personal information such as their address will be available for anyone good or bad as public information.  If published as requested, The NH Patriot Guard is not responsible for information misuse. 
  • PGR organized events and projects assisting wounded soldiers and their families as defined by the HOTH criteria.
  • PGR organized Welcome Home and Troop Send Off.
  • Military Appreciation Ceremonies.
  • Any event honoring our wounded heroes, such as Purple Heart ceremonies.
  • When posting a help request for another state, coordinate with that state’s SC and/or HOTH Coordinator.  Let them post it and take ownership if they decide the NHPGR will support it.

NOT A HOTH EVENT UNLESS PGR ORGANIZED 

  • Picnics and parades go in the state forum and are not HOTH missions.
  • Poker Runs and fundraisers will go in the state forum and are not missions unless they are initiated, or approved by the New Hampshire PGR SC or DSC.
  • Poker runs, picnics, parades, fund raisers and any other events will be posted in the respective state forum.
  • Missions for family members of heroes or PGR members (subject to PGR SC approval).
  • Reunions
  • Benefits
  • Collection of funds for other organizations, unless funds are equally shared with the PGR.
  • Website reference unless it is in direct support of the HOTH mission (State forum).
  • News references unless it is a direct result of HOTH then it should be referred to the State Captain or HOTH Coordinator.
  • Support of the parents of a fallen hero may not be a HOTH mission after the honor mission unless it is authorized by the SC or National.  If so authorized it will most likely be posted in the corresponding state forums.

Anything that is referred to the above should be entered into the other supporting  organizations forums or your state forum.

CATASTROPHICALLY WOUNDED SOLDIER CAMPAIGN

The PGR will pursue a three-phase approach to the Catastrophically Wounded Veteran Campaign.  As troops return to the states, those with the most severe injuries will be on “Inpatient Status” and will remain a patient until they are released back to their units or placed on “Outpatient Status” for continued physical therapy or discharged.  As recognized on the PGR homepage “PGR Visits the Troops”, involves those most severe cases which need as much support as we can give them.

PHASE ONE (INPATIENT)

  • This may very well be the hardest time for these Veterans.  They are faced with life changing injuries.  Many will not have the comfort or support of their family and friends at all times.  The PGR will attempt to befriend these wounded Veterans, establish rapport with them.  We shall attempt to become a constant in their lives, someone who can help them and show them their sacrifice is honored by a grateful country.
  • Provide information on the PGR mission.
  • Provide services as needed.

PHASE TWO (OUTPATIENT)

  • When Veterans are released from a critical care facility and begin a regular program of physical and emotional therapy.  Housed at either the Soldier and Family Assistance Center (SFAC) or Fisher House, these Veterans will have the support of other military members and the facility staff.  Their freedom of movement will be greater, thus our level of support may be diminished but not eliminated.

HOTH REPRESENTATIVES WILL:

  1. Continue to monitor Veteran’s status and location.
  2. Provide appropriate services as needed.
  3. Continue Help On The Home Front support to the Veteran and the family.
  4. Provide notification to PGR state captains of impending involvement and needs from the statewide membership.
  5. Coordinate HFV efforts at the state and local levels.
  6. Report progress and communicate with the SC or DSC.
  7. Make available to the Veteran and the family a list of contacts that may prove beneficial in their lives at home.

PHASE THREE (POST MEDICAL TREATMENT AND DISCHARGE FROM ACTIVE SERVICE)

  • Some patients will find this phase of reintegration most difficult.  While the PGR does not have Veteran Service Officers for obtaining benefits for these individuals, the PGR may have members with first hand knowledge of obtaining benefits and they will gladly share that information and experiences.  The NHPGR HOTH program is not empowered to formally sign up, or commit external organizations, to provide benefits. 
  • “It is to be explicitly understood that the PGR/NHPGR while a Veterans Supporting Organization is not certified unless individually via external organizations or agencies, to provide formal services to any Veteran.” 
  • The PGR HOTH program personnel will serve as a friendly face, a listening ear, and most importantly someone showing sincere appreciation for each Veteran’s service.  The PGR will do what it can within the constraints of a volunteer organization.

FUNDING OF NHPGR HELP ON THE HOMEFRONT PROGRAM

All funding of the New Hampshire HOTH program will be coordinated through the State Captain, Deputy State Captains, and the HOTH Coordinator, and subject to approval of the New Hampshire Patriot Guard leadership to insure compliance within both State and Federal guidelines.

DISBURSEMENT OF FUNDS

The State HOTH Coordinator and state leadership will review the “request form” and then either accept, reject or return it for further information or confirmation.  When the request is approved by a Majority of the State leadership, a warrant will be presented to the State Treasurer for funds.  This check will be made out to the party to whom the funds have been requested, or as the board directs in special cases.

A tracking form will follow the funds accordingly and signed by each member as the funds are transferred from individual to individual. This will insure accountability, and is designed as a precautionary means for protection of the New Hampshire Patriot Guard riders and all involved.

These funds will be disbursed to the SC/DSC and then to the local RC’s, or their designates and signed for accordingly.  It is desired to use RC’s in the disbursement process as much as possible.  A minimum of three (3) Patriot Guard Riders will be present during the presentation of any PGR funds in excess of $100.00.

The original tracking form, as well as the original request will be sent to and kept by the State HOTH Coordinator and copies sent to the DSC, State Treasurer and SC. (See attached forms).

If the request is denied, it will be the responsibility of the State HOTH Coordinator to inform the requesting party why the request was denied, along with copies of any correspondence sent to the State Leadership.  All appeals of denial will be sent through the State HOTH coordinator for review, and possible action.  The final decision authority for all appeals will reside with the PGR SC.  Once an appeal is reviewed, and decision made, it will be final and the PGR forum will not be used as an avenue to informally continue an appeal process.

REPORTING FORM FOR EXPENSES AND REQUESTS:

Instructions:

The following form is the only form used to request Financial Assistance from the New Hampshire PGR for all HOTH related efforts.  This form is designed to prevent erroneous or fraudulent claims.  Please allow enough time for this request to be reviewed and then presented to the NH PGR Leadership for their review and decision.

Email or mail your requests to the New Hampshire HOTH Coordinator.

 

PLEASE PRINT LEGIBLY

Amount Requested:    $______________       Date Needed: _______________

(Please allow a minimum of 14 days from request date)

Date of Request:        _______________

Requested by:    _______________________________________________

Day Phone: (_____)___________ Night Phone: (_____)_______________

(what is the best time to call?)    __________________

HOTH Coordinator:_________________________________________________

Soldiers/Family/Veteran’s Name:___________________________________________

Is Veteran’s need service related: Yes___ No___

 If No, please explain:

________________________________________________________________________

Has need been verified by a NHPGR Member? Yes___ No___

Verifying Member’s Name: _____________________        Phone: (__)_________

If request is approved, please provide the following:

Check payable to: ________________________________________________________

Printed Name and Signature of individual requesting funds:

(Print Name)                                        (Signature)

Detailed Explanation:________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

 

—————————————————————————————————————————————————

DISBURSEMENT TRACKING FORM

This form must accompany the funds, and returned to the State HOTH Coordinator when transaction has been completed to ensure proper tracking and documentation.

Check #______________________________________________

Amount $_____________________________________________

Recipient of Funds _____________________________________

Address:______________________________________________

Town:____________________________  State______________

 

Print and Sign

State Treasurers Signature______________________________

Date: ________________________________________________

 

Print and Sign

State Captain__________________________________________

Date__________________________________________________

 

Print and Sign

Deputy State Captain _________________________________

Date: ________________________________________________

 

Print and Sign

Ride Captain___________________________________________

Date_________________________________________________

 

Print and Sign

Ride Captain___________________________________________

Date__________________________________________________

 

Print and Sign

Ride Captain__________________________________________

Date_________________________________________________

 

 

 

(rev 02/08/2013)