Individual Assistance Request Greater Los Angeles ChapterAssociation of the United States ArmyMilitary Assistance FundService Member Name:: *RankFirstLastMIAge:Check One:Army Reserve Army National Guard Active Duty OtherPhone number:-Area CodePhone NumberE-mail:Unit Name:Unit Location:Reason for Request - Briefly explain what assistance you need and reasons for request (i.e. lost job, etc.):$ Amount of Assistance Requested *Attach copy of bill(s) or invoice(s):Payment to be sent to:Name:FirstLastAddress:Street AddressCityStatePostal / Zip CodeAccount Number (if available):Phone:-Area CodePhone NumberE-mail (if available):Request submitted on service member’s behalf by:- Name:FirstLast- Organization:- Phone:-Area CodePhone Number- E-mail:Recaptcha Word Verification:type_submit_reset_33SubmitResetThis request is in response to GLAC’s offer to support Units/Soldiers/Families. GLAC/AUSA is a non-profit 501(c)(3) organization. All requests need to be supported with verification (i.e. DD-214, copy of bill, etc.). No direct cash payments to Soldiers/Veterans are made. Payments are only made to companies, etc., verified on invoices.Request should be submitted by 3rd party individuals or organizations with direct knowledge of the service member’s situation and circumstances. Requests should not come directly from the service member.