Get Wtc Health Program Responder Eligibility Application ... - Home - Wtc Iaff

The WTC Health Program Responder Eligibility Application is essential for determining your eligibility for the program. This guide provides clear and comprehensive instructions to help you successfully complete the form, ensuring that you provide all necessary information accurately.

Follow the steps to fill out the application effectively.

1. Press the ‘Get Form’ button to obtain the application form and access it in your document editor.
2. Enter today’s date in the designated field as day/month/year.
3. Provide your last name, first name, and middle name in the appropriate fields.
4. Fill in your mailing address, ensuring that all components are accurate, including city, state, and zip code.
5. Input your email address and contact numbers, including home, work, and cell phone numbers.
6. Record your date of birth in the specified format.
7. Indicate your gender by selecting the appropriate checkbox.
8. Choose your government identification type if desired, and provide the relevant details.
9. Describe your World Trade Center disaster area experience by checking the applicable box.
10. If necessary, provide details on how you believe you qualify for the program if you do not fit into the previous categories.
11. Complete the section regarding hours worked or volunteered each day during September 2001.
12. Detail the hours you worked or volunteered for specified weeks in October and November 2001.
13. Indicate the number of working days for the specified months up to December 2002.
14. Gather and attach the required documentation that verifies your employment or experience as requested.
15. Sign the application form to confirm the information is accurate and complete.
16. Submit the completed form either by faxing it to the specified number or mailing it to the provided address.

Please start filling out your WTC Health Program Responder Eligibility Application online today.