Veteran Application - Parsons, Chetopa, St. Paul High Schools Honor Flight Hub - Kansas

Parsons, Chetopa, St. Paul High Schools Honor Flight recognizes American Veterans for your sacrifices and achievements by flying you to Washington, DC to see YOUR memorials at no cost. For our Honor Flight to achieve this goal, high school guardians fly with the Veterans on every flight, providing assistance and helping Veterans have a safe, memorable, and rewarding experience. Veterans are accompanied on their flight by guardians who serve as escorts to the Veterans. We select our high school guardians from our designated schools based on their character and compassion, as well as their capabilities to perform the minimum requirements.


Top priority is given to WWII and terminally ill Veterans from all wars. After WWII and terminally ill priority is as follows: those who served between WWII and Korean War, Korean War Veterans, those who served between Korean and Vietnam Wars, then Vietnam War Veterans. Although we are not yet serving Veterans post 1975, you may submit your application and we will keep it on file until your era is eligible to participate.


IMPORTANT:  Our Honor Flight DOES NOT accept family members, friends, or caretakers of a Veteran to serve as their Veteran’s guardian. Please do not encourage your family members, friends, or caretakers to apply for guardian status, as their application will not be considered.


Thank you in advance for submitting your application and allowing us the honor of escorting you to Washington to see your memorials. We also want to extend our appreciation to you for your service and sacrifice to our great country. For what you and your comrades have given to us, please consider this a small token of appreciation from our Honor Flight. 


If you would prefer a hard copy of the application to complete please email one of the following individuals:

Bobbi Williams - bwilliams@usd505.org

Debbie Shaffer - dshaffer@vikingnet.net

Kristy Mueller - kmueller@usd505.org


Email *
Name as it appears on your driver's license
 *
Nickname
Street Address or PO Box *
City *
State *
Zip Code *
Cell Phone *
Home phone number
Email - that you check regularly
Date of Birth *
MM
/
DD
/
YYYY
T-Shirt Size *
Gender *
Branch of Service
 *
Rank *
Service Dates - please select the date that reflects your earliest year of service *
Activity During Service *
The next several questions concern your physical health.  Medical information provided will not disqualify you from participation; it permits us to assess the support needed during the Mission.  Medical information will be shared with Mission Medical personnel and as needed with other Honor Fight personnel.

Medications:  Please list all medications and how often taken
 *
Mobility:  What type of mobility equipment do you use *
Drug Allergies:  Please list drug allergies *
Seizure History:  Do you have a history of seizures *
If yes to above, what is the date of your last seizure?

If you have had a seizure in the last five years, it is strongly advised to discuss travel with your doctor.
Do you get motion sickness *
Do you have breathing problems *
If yes to above, please explain your breathing problems
Do you use a home nebulizer *
Do you use oxygen at any time?

If yes, you will need an oxygen prescription from your doctor to be able to use oxygen during the trip. Oxygen will be provided. We will request the prescription when you are selected for a Mission.
*
Do you have a problem walking the length of a football field without assistance? *
If yes to above question, please explain the issues you have with walking the length of a football field (heart or lung problems, arthritis, etc).
Do you have a history of open head injuries, sinus problems, or ear problems *
If yes to above question, concerning head injuries, sinus or ear problems, have you flown since the onset of the problem?
Do you have an ostomy or colostomy bag? *
Do you smoke, vape, or use smokeless tobacco? *
Additional Medical Concerns
Emergency Contact Number 1:  Please provide name, mailing address, cell phone number, and email. *
Emergency Contact Number 2:  Please provide name, mailing address, cell phone number, and email. *
By entering my name here, I give consent for a background check.
Please read carefully:  By entering your name, you acknowledge and agree that:

1. As photographic and video equipment are frequently used to memorialize and document 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 Honor Flight program. I release the photographer and Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during Honor Flight activities through video, photo, or other media to be used solely for Honor Flight promotional material and publications, and waive any rights or compensation or ownership thereto. 

2. I further state that medical insurance is the responsibility of the veteran, and I understand that neither Honor Flight nor the provider of free private aircraft ("Flight Provider") provides medical care. I understand that I accept all risks associated with travel and other Honor Flight Network activities and will not hold Honor Flight, the Flight Provider, or any person appearing or quoted in any advertisement or public service announcement for or on behalf of Honor Flight responsible for any injuries incurred by me while participating in the Honor Flight program.               

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