Veteran Program

Apply for exclusive discounts for Veterans
thank you for your service

First Name *

Last Name *

Email Address *

Phone Number *

Military Branch *

Enlisted Date *

/ /

Discharge Date *

/ /

DD214

(Just right-click your scanned DD214 image and “Copy image address”)

Other Proof of Military Service

Consent to be contacted * I agree to be contacted by a PHS representative to verify the above information.

Email Opt-in By submitting this form, you agree to be contacted about PHS’ programs and promotions.