Marine Corps Engineer Association



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Marine Corps Engineer Association

Application for Financial Assistance

To ensure your application is reviewed and processed as quickly as possible, please read and follow the procedures on the cover letter and application.

Eligibility: All applicants applying to the Fund must:

• Have had military service with, or attached to, a Marine Corps engineer or EOD unit,

• Or, are the unmarried spouse of a deceased Marine Corps Engineer

• Provide proof of service, and/or proof of relationship.

• Complete Financial Assistance Application

Policy: This application is to be used if you are seeking Financial Assistance. Proof must be provided regarding Marine Corps MOS designations and/or service when attached to, or in support of, Marine Corps Air Ground Task Force (MAGTF) Engineer Units. If the applicant is an unmarried spouse of a deceased member of the Marine Corps engineer or EOD community, proof of the relationship must be provided.

PART 1: REASON FOR APPLICATION

Briefly state the reason you are applying for financial assistance: _________________________________________________________

___________________________________________________________________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

PART 2: APPLICANT GENERAL INFORMATION

Name: ____________________________________________________________

First Middle Last

Mailing Address: ____________________________________________________

City: __________________________ State: __________ Zip: _______________

Telephone: (______)________________ Email: ___________________________

Date of Birth: ______________ Married (circle as applicable): Yes No

PART 3: APPLICANT STATUS

After completing PARTS 1 and 2 above, check the applicable box below, and complete the additional parts of this form as indicated:

□ Active Duty or Reserve Component: Complete PARTS 4, 6, 7, 8, and 9

□ Veteran or Retiree: Complete PARTS 5 through 9

□ Unmarried Surviving Spouse: Complete PARTS 5 through 9

PART 4: SERVICE INFORMATION

a. Unit Designation (name) and mailing address of your current active or

Reserve command: _____________________________________________

_____________________________________________________________

b. Expected date of discharge or end of current enlistment: ____/____/____

c. USMC Primary MOS __ __ __ __ Secondary MOS __ __ __ __

d. Which MAGTF engineer units are you assigned, or have been assigned, to, or in support of/attached to: ________________________________________

_____________________________________________________________

_____________________________________________________________

PART 5: ELIGIBILITY INFORMATION

Fill in the following information for yourself if a veteran, retiree, or unmarried surviving spouse. If you are completing the form on behalf of someone else, provide the information for the person for whom you are applying.

a. Eligibility is based on:

□ Your own service

□ The service of another (Provide full name, Service number, and Service): ______________________________________________

______________________________________________________

b. Applicant is a:

□ Veteran

□ Retiree

□ Unmarried surviving spouse

□ Other—explain: ______________________________________

c. Provide any of the following information not contained on the most recent copy of your (the) DD Form 214:

Service (if other than USMC): _______________

Primary MOS __ __ __ __ Secondary MOS __ __ __ __

MAGTF engineer units to which assigned to, in support of, or attached to (include inclusive month/year(s)):

______________________________________________________________

______________________________________________________________

______________________________________________________________

PART 6: SUPPORTING INFORMATION

a. Total value of each of the following that you own:

Home …………………………..………. $ __ __ __, __ __ __

Second home...……………………..….. $ __ __ __, __ __ __

Recreational vehicle …………..………. $ __ __ __, __ __ __

Boat/water craft …………………..……. $ __ __ __, __ __ __

Bank accounts, savings, & investments $ __ __ __, __ __ __

Other …………………………………….. $ __ __ __, __ __ __

b. Estimated total average household monthly income:

Total salaries, wages, and pensions (net) ….… $ __, __ __ __

Financial aid/assistance (government furnished) $ __, __ __ __

Financial aid/assistance (non-government) …… $ __, __ __ __

Student loans …………………………………….. $ __, __ __ __

Scholarships ……………………………………… $ __, __ __ __

Financial support from family …………………… $ __, __ __ __

Income from investments, trusts, etc. …………. $ __, __ __ __

Other income (net) …………………………….…. $ __, __ __ __

c. Estimated total average household monthly expenses:

Mortgage(s)/rent ………………………….……… $ __, __ __ __

Other loans (e.g., car, boat, etc.) except student $ __, __ __ __

Student loans …………………………………..… $ __, __ __ __

Credit card payments ………………………..….. $ __, __ __ __

Insurance (all not already included in mortgage) $ __, __ __ __

Food and personal/household supplies ………. $ __, __ __ __

Clothing ……………………………………………. $ __, __ __ __

Utilities ……………………………………………… $ __, __ __ __

Phone, internet, cable ……………………………. $ __, __ __ __

Entertainment ……………………………………… $ __, __ __ __

Alimony, child support, and garnishments …….. $ __, __ __ __

Tuition/books/school fees ……………………….. $ __, __ __ __

d. All other expenses (Explain below for any expense

item(s) included in the this total which exceeds $ 50

per month) …………………………………………… $ __, __ __ __

_______________________________________________________________

_______________________________________________________________

e. Have you, or any other member of your household applied to any other charity/society for financial assistance?

(circle as applicable): Yes No

If yes, please give details and state results, if known: _____________________

_______________________________________________________________

_______________________________________________________________

Number of persons (including yourself) living in your household: # ________

Total number of vehicles you own: # ________

Total household credit card debt: $ __ __, __ __ __

f. Have you filed for bankruptcy in the past five (5) years (circle as applicable)?

Yes No

If you answered YES with regard to bankruptcy, are there any Judgments or Liens against you or any member of your family (circle as applicable)?

Yes No

If you answered YES with regard to Judgments or Liens, please explain: _____

________________________________________________________________

PART 7: OTHER INFORMATION

a. If there is any additional information you want to be considered regarding this application, explain below:

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

b. If your application is for financial assistance to attend college or vocational school, then complete the following:

Are you enrolled, or awaiting acceptance in a:

□ Vocational/Trade school

□ College or university as an undergraduate

School or college name and address: ________________________________

_______________________________________________________________

Your student ID number (if applicable): ____________

Are you:

□ A part-time student-------Current GPA: _______

□ A full-time student--------Current GPA: _______

□ Accepted, but have not yet started classes

□ Awaiting acceptance (pending)

□ None of the above

Financial department to send a check on your behalf: __________________

______________________________________________________________

PART 8: SUBMISSION REQUIREMENTS

a. If there is not enough space on the form, attach additional sheet(s) as needed. Reference the PART and paragraph which applies.

b. If the applicant is currently serving on active duty, a member of the Reserve component, a military retiree, or dependent/surviving spouse, provide a copy of the front and back of your current military ID card.

c. If the applicant is a veteran or retiree, provide a copy of your last DD Form 214.

d. If the applicant is a surviving spouse, provide a copy of the last DD Form 214 for the service member under whom you are claiming eligibility.

e. For all applicants requesting financial assistance for undergraduate studies or vocational schooling, provide verification of enrollment.

f. Submit a notarized statement if you are otherwise unable to submit any official documentation which verifies your current status (.e.g, active duty, reserves, dependent, etc.). Also, a notarized statement is required If you are a veteran, retiree, or surviving spouse, and unable to submit any documentation which verifies MOS, and service with MAGTF engineer and EOD units.

g. Complete the checklist below, and attach the applicable documents:

Copy of front and back of Military ID card

□ Required

□ Not applicable or not required

Copy of last DD Form 214

□ Required

□ Not applicable or not required

Notarized statement(s)

□ Required

□ Not applicable or not required

Verification of enrollment

□ Required

□ Not applicable or not required

Supplemental pages/attachments

□ Required

□ Not applicable or not required

h. Complete this form as instructed, and sign and date.

Application is completed, signed, and dated

□ Required

PART 9: FINANCIAL ASSISTANCE AWARD

This application is for financial assistance provided through the Marine Corps Engineer Association, and made possible by the generous contributions of its donors. Funds will be distributed as available and at the discretion of the Executive Committee of the Marine Corps Engineer Association Assistance Fund. The submission of this application does not guarantee an award will be granted. By submitting this application, you are authorizing the MCEA to request and obtain any further information it deems necessary to consider your request.

I understand that concealment of any facts or fraudulent statements made herein may result in forfeiture of my consideration for financial aid from the MCEA. I authorize any person, organization or agency to disclose any and all applicable information to the MCEA, its officers or representatives. I also understand that the information presented in this application and any obtained will be held in confidence by the MCEA.

Signature of applicant: _______________________________ Date: ____________________

SEND TO

Chairman, MCEA Assistance Fund

269 Creedmoor Road

Jacksonville, NC 28546

The Marine Corps Engineer Association Assistance Fund

Notary Public Form

STATE OF____________________________________

COUNTY OF__________________________________

On this ______________ day of ___________________, in the year of 20____, before me, the undersigned a Notary Public in and for said STATE, personally appeared _________________________, a person known to me (or proved to me on the basis of satisfactory evidence) to be the person whose name is subscribed to within the written instrument, and acknowledged to me that he/she executed it.

WITNESS my hand and official seal.

_______________________________

Notary Public

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