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Blue Devil Association
Contact Us

Here's how to get in touch with us Email:  couillardks@gmail.com

Completed the form below.  Copy/scan and email or mail the form to the addresses provided, and we will get back to
you as soon as we can. We look forward to hearing from you.

                                       BDA Request Checklist
Date: ________________________________________________________________________________________________
Soldier's Full Name & Rank to be considered for BDA funds: ___________________________________________________
Who is requesting assistance-check one:  ____ 88th Soldier or  ____ Spouse or other (identify relationship to Soldier) : ___
_____________________________________________________________________________________________________
Current Mailing Address with zip code: _____________________________________________________________________
Current Unit: __________________________________________________________________________________________
Current Phone number Day time:___________________________ Evening:_______________________________________
Referred by: ___________________________________________________________________________________________
Name and Contact Information for someone in Soldier’s COC who has validated the financial emergency
(ex.: 1SG/NCOIC/XO/Commander): ________________________________________________________________________
 
What are the circumstances (what has happened/why emergency financial assistance needed) ____________________________________
 
______________________________________________________________________________________________________

______________________________________________________________________________________________________
 
__________________________________________________________________________________________________________________

___________________________________________________________________________________________________________________
 
Dependents & Ages: _____________________________________________________________________________________

 
Recommended Grant Amount: _____________________________________________________________________________________
 

Forward this request to: Kathleen Couillard, LTC USA (Retired),  email: couillardks@gmail.com 

If need long term assistance, contact Military OneSource at:

1-800-342-9647 - 24 hours a day, seven days a week or other assistance options.

Thank you for visiting our web site!
 
 
 
 
 
 
 
     Blue Devil Association
     PO Box 23462, Richfield, MN 55423-0045