Kansas Honor Flight | Guardian Registration Form

Guardian Information

First Name

Middle Name

Last Name

Nickname (if used)

Date of Birth

Gender

Male Female

Contact Information

Street Address

City

State

Zipcode

County

Daytime Phone

Evening Phone

Mobile Phone

Email Address

Travel Information

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

Yes No

Can you lift 100 pounds?

Yes No

Additional Information

T-Shirt Size

Are you willing to assist all veterans, and are you willing to push any wheelchair?

Yes No

Occupation:

Please list any prior Volunteer experience:

Remarks / Comments:

How did you hear about Honor Flight?

Emergency Contact

The Emergency Contact should be someone available on the day of the trip.

First Name

Last Name

Relationship

Address

City

State

Zipcode

Daytime Phone

Evening Phone

Mobile Phone

Email Address