Military Training Instructor Benevolent Fund
Name: _____________________________________ Rank: ________________________
Address: _______________________________________________ State: ________________
Zip Code: _________________________ Email: ___________________________________
Telephone Number (Include Area Code): ____________________________________________
MTI Service Period: _____________________ BMT Unit: __________________________
What is your specific need: _______________________________________________________
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Please provide the name and contact information of someone who can verify your claim: _____
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I certify that I am or was an Air Force Military Training Instructor whose principal duty as an instructor was to conduct basic military training. I am not claiming any eligibility to receive assistance as a result of duty as a technical school instructor or any other secondary instructor duty.
I further certify that the information I have provided is accurate to the best of my knowledge. I understand that knowingly submitting information that is fraudulent is a criminal act and could subject me to criminal prosecution or civil action.
I understand that the information submitted within the application is privileged and is for the specific use by the Military Training Instructor Benevolent Fund in considering my application. I expressly waive and hold harmless the Fund and any Officer of the Fund from any and all claims that could arise as a result of this application.
This the _______ day of __________________, 20______.
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Printed Name and Signature
Mail all applications to MTI Benevolent Fund, P.O. Box 276477, San Antonio, TX 78227-6477