Applications

Application type

Veteran
Guardian

Please choose whether you're applying as a Guardian or a Veteran.

All volunteer guardians must complete an application to be considered for a flight. Guardians are required to pay their own flight expenses, which is $500 per person. Please read the frequently asked questions below. Complete the application form below or print and mail the completed form to Freedom Honor Flight, P.O. Box 505, La Crosse, Wisconsin, 54602-0505.

Guardians play a significant role on every Freedom Honor Flight, ensuring that every veteran has a safe and memorable experience. Duties include, but not limited to, physically assisting the veterans at the airport, during the flight and at the memorials. Guardians must be between 18 and 70 years of age. Guardians are also responsible for their own expenses (airline fare, etc.). For further information, please contact us at (608) 784-1015 or www.freedomhonorflight.org/contact-us. Thank you for your support!

All veterans must complete an application to be selected for a flight. We require certain personal and medical information so our medical director and team members can ensure the veteran will physically and comfortably be able to make the flight. Please read the frequently asked questions below. Complete and submit the form below, or print and mail the completed form to Freedom Honor Flight, P.O. Box 505, La Crosse, Wisconsin, 54602-0505.

Freedom Honor Flight recognizes American veterans for your sacrifices and achievements by flying you to Washington, DC to see YOUR memorial at no cost. Top priority is given to WW II and terminally ill veterans from all wars. In order for Freedom Honor Flight to achieve this goal, guardians fly with the veterans on every flight providing assistance and helping veterans have a safe, memorable and rewarding experience. For what you and your comrades have given to us, please consider this a small token of appreciation from all of us at Freedom Honor Flight. For further information, please contact us at (608) 784-1015 or www.freedomhonorflight.org/contact-us. Thank you for your support!

Select your state*

Iowa
Minnesota
Wisconsin

Wisconsin*

Select to confirm Freedom Honor Flight is the hub closest to your location.

Iowa*

Select to confirm Freedom Honor Flight is the hub closest to your location.

Minnesota*

Select to confirm Freedom Honor Flight is the hub closest to your location.

Name*

First Last

Please enter your name as it appears on your ID for airline travel.

Preferred name (if different from above)

Address*

Street Address Address Line 2 City State ZIP Code

Daytime phone*

Evening phone*

Mobile phone*

Date of birth*

Email address*

How did you hear about Freedom Honor Flight?

T-shirt size*

Weight*

Occupation*

Are you a veteran?

If a veteran, please indicate BRANCH of service, and WHEN and WHERE you served

How did you learn about the Freedom Honor Flight organization?

Why are you volunteering for Freedom Honor Flight?

Please list any prior volunteer experience

Alternate contact

Son, daughter, etc.

Name*

First Last

Relationship*

Phone*

Email*

Personal reference

Please list one reference.

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email*

Daytime phone*

Evening phone*

Emergency contact

Someone available the day you travel.

Name*

First Last

Reltationship to you*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email

Daytime phone*

Evening phone

Service history

Branch of service*

Rank*

Home town*

From which city and state did you enter the service?

Dates of service*

Activity during WWII, Korea, Vietnam

I certify that I served during one of the following periods: (Please check one)*

U.S. Merchant Marines -- December 7, 1941 to August 15, 1945
WWII -- December 7, 1941 to December 31, 1946
Korea -- June 25, 1950 to January 31, 1955
Vietnam -- February 28, 1961 to May 7, 1975

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Guardian only information

Are you requesting to travel with a specific veteran, if possible?*

If yes, please name the veteran

Please note that completed veteran application must be submitted separately.

Can you lift 100 pounds?*

Please identify any physical disabilities, restrictions and/or medical conditions that would limit your ability to fulfill the duties of a guardian. Also, please list any medications being taken and how often

Please note any medical experience you may have

e.g. EMT, CPR, Paramedics

The undersigned acknowledges and agrees that:

Publicity

As photographic and video equipment are frequently used to memorialize and document Freedom Honor Flight trips and events, his/her image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the Freedom Honor Flight program. I hereby release the photographer and Freedom Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during Freedom Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Freedom Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto. I hereby give my permission to Freedom Honor Flight to release my name and telephone to news media. I understand I am under no obligation to consent to interviews with news media.

Insurance

I further state that medical insurance is the responsibility of the individual passenger and I understand that Freedom Honor Flight does NOT provide medical care. I understand that I accept all risks associated with travel and other Freedom Honor Flight activities and will not hold Freedom Honor Flight responsible for any injuries incurred by me while participating in the Freedom Honor Flight program.

Payment

I further agree that I will furnish payment in full to Freedom Honor Flight by no later than twenty (20) days prior to the departure of the flight to which I am assigned. I understand that failure to furnish payment by that deadline will result in my being removed from the flight.

Hidden

Veteran only information

Medical

Information provided will not disqualify you. It permits us to assess the support we need during the trip. Info is for Freedom Honor Flight and medical personnel only.

Do you use mobility equipment?*

If yes, please select device(s)

Cane
Walker
Wheelchair
Scooter

Medications

Medication taken	How often?

Name and how often you take it.
(use the "+" button on the right to add additional rows)

Do you have any drug allergies? If so, please list below.

Do you have a history of seizure?*

Please describe the type of seizure.

i.e. grand mal, petit mal, other

When was your last seizure?

If within the past 5 years, we STRONGLY advise you to discuss the trip with your physician, and we may require a signed clearance from your physician.

Do you have problems with motion sickness?*

i.e. sea or air

Is it controlled with medications?

If motion sickness is not controlled with medications, it is STRONGLY advises you discuss the trip with your physician.

Do you have any breathing problems?*

Please describe

Do you use a home nebulizer machine?*

If yes, you are STRONGLY encouraged to discuss the trip with your physician concerning the use of portable hand-held nebulizers during the trip.

Do you need access to an oxygen tank at any time?*

If yes, we will need your physician to write a prescription for oxygen to be used during the flight and during the tour. Oxygen will be provided. The prescription should be turned in with the application.

Do you have a problem walking the length of a football field without assistance?*

Please describe the reason

e.g. lung problems, arthritis, heart problems, etc.

Do you have a history of open head injuries, sinus problems, or ear problems?*

Have you flown since the open head injury, sinus or problems occured?

Did you have any problems?

If yes, it is STRONGLY advised you discuss the trip with your physician. If you have NEVER flown since the open head injury, sinus or ear problems, again we STRONGLY advise you discuss the trip with your physician.

Did you have a urostomy or colostomy bag?*

If yes, please make sure the bag is vented prior to flight. If you do not know if your bag is vented, it is STRONGLY advised you discuss this issue with your physician.

Are you requesting to travel with a specific Guardian, if possible?*

Please note that a completed Guardian application must be submitted separately and the Guardian CANNOT be a spouse or significant other.

Please name the Guardian

Additional comments or concerns

The undersigned acknowledges and agrees that:

Publicity

As photographic and video equipment are frequently used to memorialize and document Freedom Honor Flight trips and events, his/her image may appear in a public forum, such as the media or a website, to acknowledge, promote or advance the work of the Freedom Honor Flight program. I hereby release the photographer and Freedom Honor Flight from all claims and liability relating to said photographs. I here by give permission for my images captured during Freedom Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Freedom Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto. I further consent to my name and telephone number being given to news media to allow them to contact me for interviews. I understand I do not have to consent to be interviewed by the news media if I do not wish to do so.

Insurance

I further state that medical insurance is the responsibility of the individual passenger and I understand that Freedom Honor Flight does NOT provide medical care. I understand that I accept all risks associated with travel and other Freedom Honor Flight activities and will not hold Freedom Honor Flight responsible for any injuries incurred by me while participating in the Freedom Honor Flight program.

Hidden

Signature

Signed*

Please type your full name.

Today's date*

To indicate a successful submission of your application, you will be redirected to a confirmation page and an email will be sent to the address you provided above.

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Service Area

Apply online or download an application

Apply online

Alternate contact

Personal reference

Emergency contact

Service history

Guardian only information

Publicity

Insurance

Payment

Veteran only information

Medical

Publicity

Insurance

Signature