• Veterans Emergency Financial Assistance Program Application

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  • Eligibility and Instructions:

  • Veterans Forward may provide financial assistance for a veteran who is a resident of Maine and demonstrates a financial need that includes, but is not limited to the following areas:

    1. Damage to home due to fire, flood or hurricane that is not fully compensable by insurance;
    2. Illness or the illness of an immediate family member;
    3. Hardship that would result in the veteran becoming homeless;
    4. Experiencing hardship and has filed a valid VA pension and is awaiting a decision.

  • Complete application and attach all documents identified below. If you cannot attached the document send the fully developed application in one single email or via US Mail, attention to Veterans Forward:

    Fedcap Attn: Veterans Forward 220 Maine Mall Road South Portland, Maine

    E-mail: veterans@eastersealsmaine.org

  • Checklist:

    Please gather the documents now before moving on to the next step.
  • Documents used to support your application.

  • Veteran’s Emergency Financial Assistance Program (VEFAP) Application

  • Service Member/Veteran Information

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Military Branch and Service Information

  • Component*
  • Are You*
  • Active Duty Time Other than Training*
  • When Separated
  • Discharge Status*
  • Proof of Veteran Status*
  • Dates of Service (Start Date)
     / /
    2 digit month, 2 digit day, 4 digit year
  • Dates of Service (End Date)*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Service Era

  • Additional Information

  • Is the veteran working with another agency?*
  • Minor Children*
  • Do minors reside with SM/V?*
  • Does SM/V have transportation?*
  • Does SM/V have a job?*
  • Does SM/V need a job?*
  • Housing*
  • Does family have insurance? (Check all that apply)*
  • Is SM/V a class member under Maine Consent Decree?*

  • Explanation of Need and Long-Term Plan

  • In the last week, have you had any thoughts of harming*

  • If you answered yes to the above question, please visit your nearest emergency room. 

    Veterans in crisis or needing support can call the Veterans Crisis Line at 988 (Press 1), text 838255, or chat online 24/7 for confidential assistance.
    Veterans Crisis Line
    The Veterans Crisis Line provides free, confidential support to veterans, service members, National Guard and Reserve members, and their families. You do not need to be enrolled in VA benefits to access help. You can reach trained responders:

    Call: 988, then Press 1
    Text: 838255
    Chat: Online at veteranscrisisline.net

    I hereby affirm the information I have provided is true and accurate to the best of my knowledge and that I have not received financial assistance under the Veteran’s Emergency Financial Assistance Program within the last 12 months.

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year

  • Veterans Forward Financial Assessment

  • Financial Sustainability Assessment*
    Rows

  • Average Monthly Household Expenses

  • Financial Sustainability Assessment*
    Rows

  • Assets

  • Financial Sustainability Assessment*
    Rows

  • Veterans Forward VEFAP Financial Assistance Program Policy and Agreement Form

  • Please read and sign at the bottom aggreeing you understand the program and its policies.

    • I understand that the Veterans Emergency Financial Assistance Program is intended for emergencies and critical unmet needs.
    • I understand that bank statements and proof of income may be required in order for this request to be considered. I further agree to provide complete, accurate information as requested and understand that failure to do so may affect eligibility for assistance.
    • I agree to participate actively in a plan for self-sufficiency and understand that further assistance will be contingent upon this active participation. If a referral for financial counseling or other services is part of the plan, and I choose not to connect with the referral, I may not be eligible for further financial assistance.
    • I agree that my demographic information will be shared with the Maine Bureau of Veteran Services to meet contractual reporting requirements.
    • I certify that all information I have provided during intake is true and correct to the best of my knowledge for purposes of applying for financial assistance.
    • I grant permission to Veterans Forward to verify all information on my financial assistance
  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year

  • Upload All Relevant Documents Below

  • Documents used to support your application. Check the documents used to support your application:

  • Right to Appeal: If you are denied you may request reconsideration and review by the Director of Military & Veteran Services of Easterseals Maine - Veterans Forward.

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