SomerVet Registration Form

Fill out the form below to be informed of veteran-related events and opportunities in the City of Somerville.

Are you a current, former, or prospective Somerville resident?

What years did you live in Somerville?

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Area CodePhone Number

E-mail

We will not sell or spam your email address.

What best describes your age range?

What is your gender identity?

Branch or branches of service:

Service status:

Base or installation assigned:

Other base or installation:

Era(s) of service:

Please describe the year range(s) of your service

Would you describe yourself as any of the following?

Do you currently receive services or assistance?

Do you receive any of the following services or assistance?

Please describe the other non-profit or social service agency:

If you are in need of new or additional services or assistance, please specify below:

Which school(s) did you attend?

What best describes your employment status?

Are you, or have you ever been, a City of Somerville employee?

Which City department(s) were you employed with?