Coast Guard Registration

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Objective:

The objective of the Emergency Bridge Fund Gift Card Program is to provide immediate aid for basic needs —groceries, diapers, household essentials— to Active-Duty Coast Guard families in a time of crisis through gift cards to the following local grocery stores.

Acme
ShopRite
Grocery Outlet Rio Grande
Aldi

Eligibility: This program is open to Active-Duty Coast Guard Members and their families who either reside in or are stationed in Cape May County.

APPLY TO THE EMERGENCY BRIDGE FUND GIFT CARD PROGRAM

Please complete the form below and submit.

This field is for validation purposes and should be left unchanged.

**Please note this program is offered on a first-come, first-served basis and is dependent on the pool of funds available within our Emergency Bridge Fund.

Coast Guard Member Name(Required)

First Middle Last Suffix

Coast Guard Member Rank(Required)

Coast Guard Member Unit(Required)

Living Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number of Coast Guard Member(Required)

Email Address of Coast Guard Member(Required)

Total Family Member(Required)

Signature Box(Required)

Date(Required)

Name of person completing this form(Required)

First Last

Email address of person completing this form(Required)

Phone number of person completing this form(Required)

Will you prefer a pick up?(Required)

We are willing to also offer a meet up time for pick up of the gift card due to slow mail and immediate need.

Yes

Coast Guard Registration

Call To Actions

Become a Volunteer

Coast Guard Registration

Call To Actions

Become a Volunteer

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