LifeGR® Registration FormThank you for your interest in LifeGR®. Please complete the registration form below if you are seeking our services. Please enable JavaScript in your browser to complete this form.Eligibility - Step 1 of 3Am I eligible? *Military VeteranCurrent Military Service MemberFirst ResponderFormer First ResponderImmediate Family of Veteran, Military, or First ResponderSignificant Other of Veteran, Military, or First ResponderI am a...How did you first learn about us?CaregiverFamily MemberFellow Service MemberFriend (non-service member)MailPublication (magazine, newspaper, etc)RadioSocial MediaTelevisionLifeGR WebsiteHeroRaise WebsiteWhy are you registering with LifeGR®?SheWillStay® Growth GroupsPost Traumatic Stress Growth and Reconstruction CoachingAdrenaline TherapySocial Support / EngagementIt's PrivateHow familiar are you with LifeGR®?Not at AllSomewhatFamiliarVery FamiliarNextMilitary Discharge HonorableGeneral Discharge Under Honorable ConditionsOther Than Honorable (OTH) dischargeBad Conduct discharge (issued by special court-martial)Dishonorable dischargeEntry-level SeparationMedical SeparationSeparation for Convenience of the GovernmentRequired for veteransUpload your most recent DD214 Click or drag a file to this area to upload. Required for veteransNextName *FirstLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *PhoneSubmit