Veteran Application | Pole Impact

First name

Last name

Do you identify as a woman?

Yes

Did you serve in the United States Military?

Yes

According to the VA, military sexual trauma (MST) includes any sexual activity during military service in which you were involved against your will or when you were unable to say "no" such as:

Being pressured into sexual activities
Sexual contact or activities without your consent like while asleep or intoxicated
Being physically forced to have sex
Unwanted sexual touching or grabbing, or unwanted sexual advances
Comments about your body or sexual activities you found threatening

MST can happen while on or off duty. Perpetrators can be anyone - men, women, military personnel, or civilians, superiors or subordinates in the chain of command, strangers, friends, or intimate partners.*

Did you experience sexual trauma during your time in the military?

Yes

Unsure

Did you experience combat trauma during your time in the military?

Yes

Unsure

Can you commit to attending 2-3 fitness classes a week at Pole Impact for three months?

Yes

Unsure

In which branch of the military did you serve? What is your rank? Please note that this question is purely for information purposes and has no effect on your candidacy for the Veterans Program.

Please explain why you are interested in participating in our Veterans Program, and what you hope to learn over the three month.

Please email your DD214 and VA Compensation letter to veteransprogram@poleimpact.org

I understand