Our Adopt-A-Centurion program allows communities link up directly with a Centurion applicant. We hope this will increase cross-pollination and encourage diversity within our organization. Centurion 'Adopters' will be responsible for providing emotional and spiritual support to applicants during the review period, helping us focus more directly on processing applicants and other administrative responsibilities. Our preference is for small groups (congregations or other organizations) to fill this role, as opposed to individuals, but we are open to both possibilities.

If this is something that interests you, please fill out as much information as you can and we will contact you within a few weeks to follow up. For any mandatory field that does not apply to you, please enter "none" and disregard. This process is very formative, so please feel free to email us ideas about how to streamline this section of the Purse initiative. Please see the Contact page for our email and mailing address.

Name: *

Please enter first and last here

Email: *

Phone:

Optional, but helpful

Area: *

Please enter your City and State (we'll find the Zip)

Organization: * select...Private CompanyNonprofit or Community/Public OrganizationSynagogue/Church/MosqueOther/None (I want to reach out on my own time)

Will you be Adopting on shared/work time?

Please offer the name and a brief description of the organization:

Mission Statement, Values, Vision, etc.

How would you be able to help?: *

Explain how you or your organization forsee being able to assist Centurion's Purse and/or individual applicants

Military Affiliation: * select...Active DutyReserve - DrillingNational Guard (Indicate State)Veteran/Prior Service (Indicate length of service)Retired MilitaryInactive Reserve/Guard - IRR (Indicate Remaining MSO)Service Academy (Indicate Branch)ROTC (Indicate Branch and School Year)J-ROTC (Indicate Year)Delayed Entry Program - DEPOther Training Program (Please Explain)Considering EnlistingSpouse of Service Member (Indicate Active Duty or Reserve)Spouse of Veteran/Prior ServiceSpouse of RetireeOther Military Dependent (Please Explain)Other Family Member (Please Explain)Government EmployeeDefense ContractorMilitary EnthusiastNo Affiliation

Please indicate your personal or professional affiliation with the military

Explanations:

If your selection requires elaboration, please use this space

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