Vetmet Applicant

Yes! I want to join VetMET!

Membership is available to all eligible* U.S. military veterans. * indicates required field.

Applicant

First Name *

Home Address *

(The eligible veteran's current address from the household is required, and will be used for contact purposes only. VetMET membership is confirmed by the home address in Oregon, not the name submitted on the membership application.)

Street Address *

Apt./Unit *

City/State/Zip

Home Phone

Alternate Phone Number

Email Address

Number in Household (Including primary applicant)

Mailing Address (if different from address of residence)

Street Address

Payment

Membership is available to all eligible* U.S. military veterans. The membership fee covers all people who live at the residence.

Annual Membership fee is based upon the applicants participation level ( Program selection, such as ground and air ambulance coverage) and is non-refundable.

I have read and agree to the terms and conditions of the Oregon VetMET Program * I further certify I am a U.S. military veteran and not dishonorably discharged. I understand I may be requested to present my DD 214 or V.A. ID card as proof of eligibility.