Veterans Horse Education
Thank you for registering for Gallop NYC's virtual horse education programming. These virtual sessions will be held, weekly, on Thursdays at 1:30 pm.

In order to provide free Veterans programming, we need to provide information about the people using the service to our funders. We understand that this information may be sensitive and we are committed to keeping it private. Thank you for taking the time to complete this.
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Email *
What is your full name? *
What is your address?  (City, State, Zip) *
What is your birth date?
MM
/
DD
/
YYYY
Which branch of the military did you serve in? *
What was your rank? *
Do you have a physical injury or disability (including TBI)? It does not need to be related to your service. If so, what is it? *
Have you been diagnosed with a disability? If so, what is your diagnosis? *
What is your ethnicity?
What is your gender?
How would you identify from these categories?
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