Test Request A Vest | St. Michael's Shield Project

***Test Page***

Request a Vest from the St. Michael’s Shield Project

Step 1:
Complete Form Below.

Step 2:
Select Vest Size & Submit PayPal Donation.

Read before you begin:
In order for us to send you a vest, we must confirm that you are an active peace officer. You must upload a photo of your actual Law Enforcement ID to complete this form and move to Step 2.

Step 1: Vest Request Form

Your Personal Information

First & Last Name *
Email *
Cell Phone *
Home Phone

Your Agency Information

Agency Name *
Agency Phone *
Supervisor's Name *
Supervisor's Phone
Agency Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Your ID

Upload Your Police Identification ** Accepted File Extensions (JPEG, GIF, PNG, JPG, PDF - Max File Size: 1MB)
If you cannot upload your ID, we need you to mail a copy to us: St. Michael’s Shield
c/o Vest for Life Inc.
6501 Booher Rd.
Corryton, TN 37721

Hold Harmless Release

ACKNOWLEDGEMENT AND RELEASE The Executive Director of Vest For Life and (vest recipient) have entered into an agreement for the contribution of equipment. Specifically, the Executive Director of Vest For Life has authorized and allowed Vest For Life to donate to recipient certain equipment, namely one (1) used ballistic resistant vest that is not represented or warranted by Vest For Life to meet any standard of quality, design, or suitability for any use. Now, therefore, in consideration of the foregoing, that said undersigned: ____________ does hereby acknowledge receipt and delivery of said equipment and accepts it in its “AS IS, WHERE IS” condition and without warranty of any king, express, or implied, and release, acquit, and forever discharge, hold harmless and agree to indemnify Vest For Life and its agents, servants, and successors from any and all claims for damages, causes of action, demands, rights, damages, cost, expenses, and compensation whatever for and by virtue of the fact that said Vest For Life has conveyed unto the said recipient the said property and items herein described and from any action or conduct of the said recipient, its employees, and agents or end users from which any such damages, causes of action, demands which may arise.
Authorization *
I have read, I understand and agree to each of the disclosures, authorizations, directions and indemnifications.
Your Signature *My typed name above shall have the same force and effect as my written signature.
How did you hear about the St. Michael’s Shield Project:
Please note: To facilitate the shipping of your vest, we ask for a $25 PayPal donation. This donation goes strictly toward covering the expense of shipping of your vest via UPS.

Verification

Please enter any two digits *Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:

Step 1: Complete Form Below.

Step 1: Complete Form Below.

Step 2: Select Vest Size & Submit PayPal Donation.

Step 2: Select Vest Size & Submit PayPal Donation.

Read before you begin: In order for us to send you a vest, we must confirm that you are an active peace officer. You must upload a photo of your actual Law Enforcement ID to complete this form and move to Step 2.

Step 1: Vest Request Form

Your Personal Information

Your Agency Information

Your ID

Hold Harmless Release

Verification

Step 1:
Complete Form Below.

Step 1:
Complete Form Below.

Step 2:
Select Vest Size & Submit PayPal Donation.

Step 2:
Select Vest Size & Submit PayPal Donation.

Read before you begin:
In order for us to send you a vest, we must confirm that you are an active peace officer. You must upload a photo of your actual Law Enforcement ID to complete this form and move to Step 2.