Form

Veteran Supportive Campus Qualification

Please use the form below to demonstrate how your campus or institution has successfully completed the steps to be Certified as an Arizona Veteran Supportive Campus and be included in the Veteran Supportive Campus directory.
Institution Name:
Your Name
First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number
- Area Code Phone Number
Fax
- Area Code Phone Number
E-mail
Please attach a logo or image you would like to have used on the directory for as a link to your website.
Copy and paste the URL you would like the above image or logo linked to
Institution Mission and/or Charter:
Brief background of institution (year established, etc.):
Please list the programs, resources, services, etc. you provide:
Are there eligibility guidelines for your programs, resources and/or services? If so, please describe:
How would you describe your target audience?
Is there a regulatory body that has oversight over your institution? If so, please identify the body and indicate your institution’s current status as of the date of this application:
What are the educational costs for your programs or services to service members, veterans and/or family members? If there is no cost, please indicate the types of funding source(s) that support your institution (e.g. grants, donations, etc).
Arizona Veteran Supportive Campus Criteria / Guidelines for C.A.R.E.

(refer to Certification Guidelines, Guidelines for CARE Higher Education Addendum and FAQs/Recommendations)
How does your institution:
CONNECT to the Culture? (A.R.S. 41-609.D.1, D.2) Minimum Required Areas of Focus: - Institution conducts an annual or bi-annual campus survey of student veterans (including needs, issues and suggestions of veterans) (A.R.S. 41-609. D.1). Please include a copy of the survey, survey results, and how and when survey is (was) administered. • Institution has a steering committee, including student veterans, faculty and staff to help guide the institution’s activities and focus on student veterans. Include how often the committee convenes (A.R.S. 41-609. D.2).
ASK the right questions at the right time? (A.R.S. 41-609.D.3) Minimum Required Areas of Focus: • Key staff (who regularly interact with and provide support to student veterans) receive training on issues affecting the military, veteran and family population, including, but not limited to (A.R.S. 41-609. D.3): ➢ Combat & operational stressors ➢ Key issues affecting the population (e.g. post-traumatic stress, TBI, substance use, suicide, etc.), as well as the potential impact of visible and invisible injuries and disabilities ➢ Military/veteran-specific resources and systems of care • All staff (admin staff, faculty, etc.) have knowledge and awareness of the following (able to provide information to students/families as needed) (A.R.S. 41-609. D.3): ➢ National Veterans Crisis Line ➢ Designated key staff on campus for student veterans ➢ Military/Veteran Resource Network
RESPOND Effectively? (A.R.S. 41-609.D.4, D.5, D.7) Minimum Required Areas of Focus: • Institution identifies a specific location on campus and/or on website (if primary a web-based institution) that has information and resources for student veterans, as well as family members (A.R.S. 41-609. D.7). • Institution provides orientation information specific to student veterans (A.R.S. 41-609. D.4). This may include one or more of the following: ➢ A student veteran information packet ➢ Student veteran guides for new students ➢ Optional orientation sessions for student veterans, courses/lectures specific to student veterans. • Institution promotes peer mentoring and support for student veterans (A.R.S. 41-609. D.5): ➢ This must include the provision of counseling services on-campus or referrals to other counseling and crisis resources (e.g. National Veterans Crisis Line, military support programs, VA & Vet Center counseling, community-based counseling). ➢ This may include formal and informal mentoring programs (students, faculty/staff, community members, etc.).
ENGAGE in the Military/Veteran Community? (A.R.S. 41-609.D.6, D.8) Minimum Required Areas of Focus: • Institution actively outreaches to military/veteran community, including military installations to provide information on programs, as well as to identify resources that may be of benefit to student veterans (A.R.S. 41-609. D.6). • Institution partners as appropriate and needed with public and private sector organizations to strengthen support for and success of student veterans (A.R.S. 41-609. D.8.). • Outreach (print, web, etc.) accurately reflects graduation rates for student veterans. • Outreach (print, web, etc.) clearly indicates costs, options and responsibilities for financing education
Institution Statement

(This information is not part of your online profile)
Application & Reporting Process Point-Of-Contact (POC)
Full Name
First Name Last Name
Title
E-mail
Phone Number
- Area Code Phone Number
Leadership Contact Person

If the POC is not in an executive or director‐level position, please provide the name and contact information of someone in institution leadership who has reviewed the information in this packet prior to submittal.
Full Name
First Name Last Name
Title
E-mail
Phone Number
- Area Code Phone Number
This document and accompanying materials are an accurate reflection of our institution and our activities.

Yes
It is recognized that the goal of the Arizona Veteran Supportive Campus Certification, the Military/Veteran Resource Network and the application and vetting process is to recognize institutions that operate within A.R.S. 41-609 and the Guidelines for CARE, as outlined by the military/veteran community within Arizona. Institutions that are identified as no longer operating within A.R.S. 41-609 may be contacted and subsequently removed from the Arizona Veteran Supportive Campus Certification. Institutions that are identified as no longer operating with the Guidelines for CARE may be contacted and subsequently removed from the Military/Veteran Resource Network.

Yes
It is recognized that the application and vetting process to become part of the Military/Veteran Resource Network is a voluntary process and we can request to be removed from the Military/Veteran Resource Network at any time. We also recognize that that not every institution that applies will necessarily be granted approval.

Yes
The applicant institution releases the Arizona Coalition for Military Families, its directors, employees, contractors and agents, and any supportive/partner/member institutions and their representatives from any and all liability and waives all legal claims against any of the above who acts in good faith in accordance with the application and vetting process for the Military/Veteran Resource Network.

Yes
If approved, an institution Point‐of‐Contact will be designated and responsible for our institution’s semi-annual reporting requirements and responsible for our institution’s profile in the Military/Veteran Resource Network.

Yes
© 2013 Arizona Coalition for Military Families

The Guidelines for CARE are copyright of the Arizona Coalition for Military Families, on behalf of our public and private sector partners. Contents may not be reproduced or repurposed without permission.
Should be Empty:

Veteran Supportive Campus Qualification

Arizona Veteran Supportive Campus Criteria / Guidelines for C.A.R.E.

How does your institution:

Institution Statement

Application & Reporting Process Point-Of-Contact (POC)

Leadership Contact Person

© 2013 Arizona Coalition for Military Families