Apply / Participation

Boots to Beaches, Inc. is a Virginia-registered charitable organization.
Financial and other information about this organization may be obtained from the Virginia Department of Agriculture and Consumer Services, Office of Charitable and Regulatory Programs, upon request.

Program Disclaimer: In accordance with Virginia law and organizational policy, not all aspects of sponsored vacations may be eligible for payment. Eligible expenses are determined solely by Boots to Beaches based on program guidelines, funding availability, and applicable law.

First Name

Last Name

Phone

Time Zone

Address

City

State

Postal code

Date of birth

Gender

Ethnicity

Service-Connected Disability

Yes No n/a

Veteran Era

Employment Status

Eligibility Type

First Responder Gold Star Family Veteran Military

Today's Date

Proof of Service or Applicable Documentation

Printed Name of Participant