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Applications for admission to the Martha Jo Leslie State Veterans Home of Kosciusko may be downloaded here or obtained from the County Veterans Service Officer or the Home. The completed application should be sent to the Home of choice. The Admission Committee at the Home reviews the application, and a member of the social work staff will contact the applicant's family to arrange admission. The process usually takes approximately two weeks, but may be shortened in emergency situations. At the time of approval, if no spaces are available in the applicant's Home of choice, the applicant may choose to be admitted to an alternate Home or place on a waiting list until space becomes available.


Veterans or spouses of veterans in the home must meet the following requirements:

  1. Active duty in the U.S. Armed Forces and have been discharged under other than dishonorable conditions (applicant must supply Form DD 214 or equivalent report of Separation from Service); or a spouse of a veteran who is currently a resident of a Mississippi State Veterans Home.
  2. Be or have been a Mississippi resident; however, if no Mississippi resident is waiting for admission, a non-resident may be admitted to the home.
  3. Have had a medical examination be a personal or VA-physician within 30 days of admission and, as a result, demonstrate that he/she:
    1. Does not have a communicable disease;
    2. Does not require medical or hospital care for which the Home is not equipped or staffed to provide;
    3. Does not have traits which may prove dangerous to the physical well being of other residents, employees or the veteran.


Admission Applications may be mailed to:

Martha Jo Leslie State Veterans Home
310 Autumn Ridge Drive
Kosciusko, MS 39090

or faxed to: 662.289.7824

Click on the application names below. You will need Adobe Reader to view them:

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Family's Paperwork for the Admission

Application includes:

Physician's Paperwork for the Admission

Application includes: