Thank you for your interest. To help us provide you with the most appropriate information, please complete and submit the following form ~ OR ~ Go to Contact Us for specific campus phone numbers.

For yourself or the person for who you are inquiring to live at AFRH


*=Required Information

Contact Information

If you are seeking information on behalf of a veteran, please include c/o Your Name in the address.

How did you hear about AFRH?

Please describe below if you learned about AFRH from someone like a friend, AFRH Resident, AFRH Staff Member, VA referral, family member or if you knew about AFRH because you lived or worked nearby, payroll deductions, visited AFRH, saw it on the news, etc. If you can provide a person’s name, they may be credited with the referral.

ELIGIBILITY INFORMATION

Military Category

To meet military eligibility, veterans must be non-commissioned for at least half of their service time, honorably discharged from the Armed Forces, and fall into at least one of the following categories:

(select all applicable categories and types of service below)

Military Career

Describe veteran’s military career: List all military service branches that apply (active and inactive duty), type of service, rank, grade, time, service-connected disability, retirement, wartime service, awards etc.

Military Branches:

Service Time:

How long (Y/M/D) did you serve on active or inactive duty in the Armed Forces?

Active-Duty
Active-Duty
Inactive-Duty
% SCD

Wartime Service

If you served during wartime or recieved Imminent Danger Pay, please list any wars/conflicts while you were on active-duty and identify service classification: did you serve within the officially designated War Theater (WT), did you qualify for Hostile Fire Pay (HFP) or Imminent Danger Pay (IDP), or were you assigned to provide support outside of the designated war theater during a Wartime Era (ERA)?

Examples: Vietnam/WT, Korea/ERA, Submarine Duty/HFP, Liberia/IDP, none, etc. Note: Any officially designated war theaters will be listed on the veteran’s DD-214 but IDP/HFP hostile zones may not be included. (additional documentation may be needed for those applying under Category 3 with hostile fire pay as proof of eligibility)

Insurance

All applicants must be enrolled in acceptable health insurance prior to being approved for admission. Anyone over 65 must have both Medicare A&B and Supplemental Insurance or 100% VA benefits. Those under 65 who have less than a 100% VA disability rating, must have major medical insurance covering hospitalization, medical visits and prescriptions.

Health / Independence

How soon would you be interested in moving if you are eligible?

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