Impact Team Application

Applicant must be at least 18 years or older and a policy-holding member of Degree of Honor prior to application, which means he/she is the primary insured on a life insurance certificate or an annuitant. A minimum of one month’s lead time is required for all Impact Team applications. You must receive approval from Degree of Honor prior to completing your project. Upon approval of your project, you will receive a $150 Impact Team funding card and five Impact Team T-shirts. Please have your team members’ names and shirt sizes available before filling out this application.

"*" indicates required fields

Project Information

MM slash DD slash YYYY
MM slash DD slash YYYY

Shipping Information

Who the Impact Team kit should be sent to.
Shipping address*

Team Leader Information

Name*
Are you under 18?*
Are you a Degree of Honor policy-holding member?*

Team Member #2

Name*
Is this team member under 18 years old?*
Is this team member a Degree of Honor policy-holding member?*

Team Member #3

Name*
Is this team member under 18 years old?*
Is this team member a Degree of Honor policy-holding member?*

Team Member #4

Name*
Is this team member under 18 years old?*
Is this team member a Degree of Honor policy-holding member?*

Team Member #5

Name*
Is this team member under 18 years old?*
Is this team member a Degree of Honor policy-holding member?*

Acknowledgement

Acknowledgement*