Apply For Residence


The application for admission to a Pennsylvania State Veterans Home consists of six parts and requests information needed to determine eligibility for admission.

The application must be completed and submitted in its entirety.

The applicant must complete Parts I, II, III, IV and VI. Part V must be completed and signed by a physician. Additionally, a copy of the applicant’s honorable military discharge/separation document must be submitted with the application (example: DD214). If required information is not furnished, the application will be returned for completion resulting in a delay to the admission process. Failure to keep us informed of any address change or telephone contact number could also delay or cancel your admission.

It is the policy of the Department of Military and Veterans Affairs to process all applications without regard to race, color, national origin, religious creed, age, sex, ancestry or handicap.

There is no distinction in eligibility for, or in the manner of, providing any applicant services provided by, or through, the Pennsylvania State Veterans Homes. All Pennsylvania State Veterans Homes are available without distinction to all residents and visitors; regardless of race, color, national origin, religious creed, age, sex, ancestry or handicap. All persons and organizations that have occasion to refer residents for admission are to do so without regard to the resident's race, color, national origin, religious creed, age, sex, ancestry or handicap.

In recognition of our position as a health care provider, effective September 1, 2009, our six state Veterans’ Homes will be smoke free. Smoking cessation programs will be offered by the homes. Please feel free to contact them for assistance.

PLEASE NOTE: WE DO NOT ACCEPT FAXED APPLICATIONS. Only the original application with original signatures will be accepted and must be mailed directly to the following address:

Bureau of Veterans Homes
Attn: Admission’s Office
Bldg. 0-47, Fort Indiantown Gap
Annville, Pennsylvania 17003

Download Application Form

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