Honor Flight - Top of Virginia Veteran Application
If you served in the military anytime prior to 1975, you are eligible to participate! HFTOV reserves the right to deny any application at the Board’s discretion.
First Name (as you wish it to appear on your name badge) *
Last Name *
Home Phone
Cell Phone
Street Address *
Address City *
Address State (2 digit abbreviation) *
Address Zip *
Departure Location *
Military Branch *
Service Era *
Dates of Service *
Military Rank *
Activity during service (anything you'd like to share)
Birthdate (MM/DD/YYYY) *
Shirt Size (please note these are standard mens size polo shirts) *
Emergency Contact *
Emergency Contact relationship (spouse, child, etc.) *
Emergency Contact Phone Number *
Mobility *
Please list any significant medical history we should be aware of. Please let us know if you have any food restrictions (gluten free, etc.)
Do you wish to bring a family member as your guardian? **Spouses are not permitted to be guardians. Guardians must be between the ages of 18-65 and physically able to push a wheelchair all day. *
If you wish to have a family member serve as your guardian, please enter their name here. Please note, they must complete a guardian application.
Do you have a buddy (another vet) going on this trip? If so, list their name and we will do our best to seat you on the same bus.
I understand that I will have to sign a liability waiver in order to participate. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy