In order to be eligible for the VAH program, you must be:

  • Single male Veteran within our service area (Northern California)
  • Be enrolled in, or planning to attend school or work
  • Veterans of all eras
  • Presently enrolled in an institution of higher education, vocational training school, or be employed or willing to work
  • A Veteran receiving or eligible to receive services through Veterans Affairs
  • Military Reservists or National Guard members who meet the criteria for Veteran status
  • A Veteran receiving State, Federal Assistance, or VA Disability Compensation
  • Be assessed as not meeting criteria for acute psychiatric or medical care
  • Special consideration for Veterans enrolled in or interested to be in an institution of higher education, vocational training school, or be employed

Step 1

Please print, sign & return the Department of Veterans Affairs Health Release Form

Completed forms can be:

  • Emailed to admin@vahouse.org
  • Faxed to 925.822.3185
  • Mailed to 1820 Galindo Street, Concord, CA 94520

PICTURE VERSION FOR DOWNLOAD

step 2

Submit the below web application to us:

    Name:

    Date of Birth:

    Phone Number:

    Email Address:

    City / State of Residence: (Please note: We are located in and serve Northern California):

    Gender Identity:

    Military Branch of Service:

    Date: a. Entered: b. Exit:

    Type of Discharge:

    Any Service Connected Disabilities?:

    Source of Income:

    Last Four of SSN:

    Form of Medical Coverage:

    Are you receiving any medical treatment or experiencing any medical issues?:

    Understanding the mission and goals of the Veterans Accession House (VAH), explain why you are interested in VAH, instead of another traditional transitional housing program?:

    What do you hope to accomplish during your stay? What, where, when, how and why? Explain:

    Are you currently employed? Please explain your employment situation:

    Please explain your education and any special skills:

    Are you receiving or in need of any supportive medical/ counseling services?: