Veteran Application

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VETERAN APPLICATION

Midwest Honor Flight recognizes American Veterans in NW Iowa, South Dakota, and SW Minnesota for your sacrifices and achievements by taking you to Washington, DC to see YOUR memorial at no cost to you. Top priority is given to WWII and terminally ill Veterans from all wars. Midwest Honor Flight has expanded to include Korean and Vietnam Veterans. For Midwest 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 Midwest Honor Flight.

Basic Information

Please provide your name EXACTLY as shown on your Government ID
See the listing of TSA Identification Requirements here

* Indicates required field

FIRST NAME *

Middle Name/Initial *

last name *

nickname *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Home Number *

Mobile Number *

Date of Birth (MM-DD-YYYY) *

Gender *

Shirt Size *

Emergency Contact

Contact Name *

Phone Number *

Email *

Service History

Branch of Service *

War Conflict *

Guardian

Every Veteran on a Midwest Honor Flight must be accompanied by a guardian. This person will travel with you and make sure that your day is as safe and enjoyable as possible. Midwest Honor Flight has many qualified volunteers waiting for a chance to accompany you on the flight, so you do not need to find your own guardian. However, if you do have a preference for someone in particular, list them here and have them fill out an online Guardian Application within 48 hours. We need to know in advance in order to make the arrangements. Spouses and significant others are not allowed to serve as a Guardian due to National Honor Flight Network Policies. Guardians should be intellectually, physically, and emotionally capable of caring for their veteran. We reserve the right to refuse any guardian application.

Guardian Preference *

Guardian Phone Number *

Guardian Email *

Medical Needs

MEDICAL INFORMATION PROVIDED WILL NOT DISQUALIFY YOU. IT PERMITS US TO ASSESS THE SUPPORT WE NEED DURING THE TRIP. INFORMATION PROVIDED IS FOR MIDWEST HONOR FLIGHT AND MEDICAL PERSONNEL ONLY.

Do you use a wheelchair on a regular basis? *

Yes No

Do you use prescribed oxygen outside of sleeping hours? *

Yes No

HAVE YOUR HAD OR DO YOU HAVE ANY OF THE FOLLOWING *

Cancer Cardiomyopathy Congestive Heart Failure (CHF) Dementia Heart Disease Liver Disease Multiple Sclerosis (MS) Renal Disease Respiratory/Pulmonary Disease Stroke Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease) Chronic Obstructive Pulmonary Disease (COPD)

Select all that apply

Electronic Signature

By entering your name here you are attesting that you are the person named in this application (or their authorized representative) and that the information that you provided is true and accurate. The undersigned also acknowledges and agrees that:

I understand that there are waiting lists of veterans who have applied before me and understand that Midwest Honor Flight flies Veterans, at no cost to them without governmental funding, with the policy of “first to apply, first to fly” with priority always given to any WWII Veteran or terminally ill Veteran. Failure to completely fill out the entirety of this application may result in my application being return to me or not considered for flights. I also understand that I must bring a current form of government issued photo I.D. on flight day.

Applying Veteran Signature *

Submit Application

Giving Our American Heroes One Final Tour with Honor!

Contact Us!

Midwest Honor Flight
PO Box 22
Sioux Center, IA 51250
(712) 463-2020
president@midwesthonorflight.org

DONATE WHILE YOU SHOP

98.9 cents of every dollar donated to Midwest Honor Flight goes directly to getting our LOCAL Veterans from NW Iowa, the State of South Dakota, and SW Minnesota to Washington, D.C. at no cost to the Veteran.