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HomeFront Haven Retreat Application

Before. During. After Deployment — You Belong Here.

Thank you for your interest in attending our HomeFront Haven Retreat April 17-19, 2026 in Viriginia Beach. Our retreats are designed to provide military spouses and partners with space to rest, reflect, and reconnect with themselves and others who understand the journey. Please complete this application to help us get to know you and ensure a supportive and comfortable experience for all participants.

Privacy & Confidentiality Disclaimer

HomeFront Haven collects the information in this application solely to ensure a safe, supportive,and appropriate retreat experience. All personal information will remain confidential and will not be shared outside of HomeFront Haven unless required by law or with your explicit consent.

1. Personal Information

We collect demographic information to better understand who we serve, strengthen inclusivity, and evaluate our impact. Your responses are confidential, used only in aggregate, and never affect eligibility.

First Name*

Last name*

Preferred Name

Birthday*

Do you identify as Hispanic or Latino?*

Race*

Gender*

Highest level of Education Completed*

Current Employment Status*

Household Income: *

Your spouse/partner's branch of service*

Your spouse/ partner's current military status*

Your spouse/ partner is*

Spouse/ Partner Rank*

Your current military status*

Your branch of service

Your rank

Years as a Military Spouse/Partner: *

E-mail*

Phone Number*

Current Address:

Current Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

How did you hear about us?*

2. Deployment & Family Information

Total number of Deployments experienced with your spouse/partner.*

Children*

If yes, what are their ages?

If yes, will you have childcare to attend the retreat?

3. Reason for Attending

What drew you to apply for a HomeFront Haven retreat?*

What are you hoping to gain or experience during this retreat?*

4. Wellness & Support

Have you ever participated in counseling or therapy before? *

If yes, please describe briefly i.e. When? For what? (optional):

Are you currently under the care of a mental health provider? *

If yes, please describe briefly i.e. When did you start? For what? (optional):

At this time, do you feel you may need more clinical care (therapy or counseling) than community care (peer support, relaxation, connection)?*

5. Health & Accessibility

Do you have any food allergies or dietary restrictions? *

If yes, please specify:

Do you have a severe allergy requiring an EpiPen? *

Do you take any life-saving medication (e.g., for severe allergies, diabetes, asthma)? *

If yes, please specify:

Do you have any accessibility needs or physical limitations we should be aware of? *

If yes, please specify

6. Lifestyle & Interests

What type of physical activity do you enjoy most? (check all that apply)*

Yoga / Stretching

Walking

Strength training

Running

Group fitness

Swimming

Low-impact movement

Other

How often do you engage in physical activity? *

What do you enjoy doing in your spare time?*

Is there anything that helps you feel calm, grounded, or joyful during stressful times?*

7. Final Thoughts

Is there anything else you’d like us to know to help create the best possible experience for you?*

8. Consent & Acknowledgment

By submitting this form, I confirm that the information I have provided is true and complete to the best of my knowledge. I understand that I may be asked to provide proof of service connection to verify eligibility for the retreat.I consent to HomeFront Haven contacting me using the personal information I have provided for purposes related to retreat planning, participation, or follow-up communication. I understand that my information will remain confidential and will not be shared outside of HomeFront Haven without my consent.

Signature*

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HomeFront Haven™ gives military spouses and partners a soft place to land—six months before deployment, through deployment, and for a full year after—via Anchor Circle, HomeFront Renewals, and The Steady Year with an Anchor Guide. All branches. All ranks. No judgment.

Community care, not emergency care. If you’re in crisis, call or text 988 (Veterans: press 1) or visit the nearest ER.

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Terms of Service

HomeFront Haven™ is a fiscally sponsored charitable project powered by Veterans Collaborative, a 501(c)3 organization. Donations collected by Veterans Collaborative (EIN: 88-2754506) will be fully used to support HomeFront Haven™. Please contact support@veteranscollaborative.org with any questions.

© 2025. All rights reserved. Homefront Haven.

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