Veteran Application

All veterans are encouraged to apply. Priority is given to WW2 Veterans, Korean War Veterans, and Veterans with catastrophic illness followed by Vietnam Veterans and Veterans from other conflicts. Even if you did not serve in combat you are still eligible to apply. Our mission is to take every veteran who applies. Due to a large waiting list please apply only once, your applications are kept on file.

Who is eligible to apply? Army, Navy, Marines, Air Force, Coast Guard, Reserves, and National Guard veterans serving during war or peace time, serving over seas or stateside.

The Eastern Iowa Honor Flight accepts applications from veterans in Benton, Iowa, Jasper, Jones, Johnson, Linn, Marshall, South Tama, Poweshiek and Washington Counties. Veterans from surrounding areas are welcome if they are able to fly from The Eastern Iowa Airport in Cedar Rapids.


    HONOR FLIGHT VETERAN APPLICATION

    There are two options for filling out this application. You may fill out the form below and submit it electronically by using the submit button at the bottom of the form or print a paper application and mail it in using the directions on the document.
    ALL required information must be filled in prior to submission. The information requested on these forms is necessary so that we may provide you with a safe and memorable experience. Any information you supply will not be shared with anyone outside of the Eastern Iowa Honor Flight.
    The Eastern Iowa Honor Flight recognizes all Veterans for their service, sacrifices, and achievements by flying them to Washington, DC to visit memorial and monuments dedicated to their service. The trip is no cost to the veteran. Top priority for Honor Flights is given to WW II, Korean, and terminally ill veterans. Honor Flight has also expanded to include Vietnam Veterans. In order for the Honor Flight to achieve it’s goal, a guardians must accompany the veterans on every flight providing assistance and helping veterans have a safe, memorable and rewarding experience.


    Thank you for your service and welcome home!

    For Eastern Iowa Honor Flight information, please contact our Staff at eihf.veterans@gmail.com or call at (319) 551-2020.
    * indicates a required field
    VETERANS NAME (As it appears on your ID for airline travel)
    First*:

    Middle:
    Last*:
    Nick Name: (If applicable - for name tags)
    Birth Date*:
    Gender*: MaleFemale
    Address*:
    City*:
    State*:
    Zip*:
    County*:
    Prefered Phone*:
    Alternate Phone:
    E-Mail Address*:
    Please enter the veterans dates of service*:
    From to
    Branch of Service*:
    Rank*:
    Veterans polo-Shirt Size*:
        *If Other, please note
    Tell us about your service
    List any service awards
    Occupation prior to retirement
    Company worked for
    What organizations are you actively involved in (Ex: American Legion, VFW, Rotary, etc)
    Home town (city/state where entered service)*:
    How did you hear about Honor Flight
    THE MEDICAL INFORMATION PROVIDED WILL NOT DISQUALIFY YOU. IT PERMITS US TO ASSESS THE SUPPORT WE NEED DURING THE TRIP. INFO IS FOR HONOR FLIGHT AND MEDICAL PERSONNEL ONLY.
    Do you use mobility equipment*: Yes*No
        *If Yes, please select CaneWalkerWheelchairScooter
    Do you need assistance climbing 4-5 stairs*: YesNo
    Do you need help walking 5 blocks (1/2 mile)*: YesNo
    Do you use insulin*: YesNo
    Do you use oxygen at any time*: YesNo
    Spouses Name*: or NA
    Spouses Phone*:

    REQUESTED GUARDIAN: (Spouses cannot be Guardians, National Honor Flight regulations)


    If a specific Guardian is requested, a Guardian application is required ASAP. Visit our Guardian Application for more info. If no Guardian is requested, one will be provided by the Eastern Iowa Honor Flight from the many volunteers who would be honored to spend the day with you.

    Check One* None RequestedFamily MemberFriend
    If requesting a Guardian, their application is: Submitted PreviouslyForthcoming
    First Name:
    Last Name:
    Phone:
    Email:
    Address:
    City:
    State:
    Zip:
    ALTERNATE CONTACT (Not Living with you)
    Name*:
    Relationship*:
    Phone*:
    Email*:
    Address*:
    City*:
    State*:
    Zip*:
    EMERGENCY CONTACT (Not Living with you)
    Name*:
    Relationship*:
    Email*:
    Address*:
    City*:
    State*:
    Zip*:
    Day Phone*:
    Evening Phone*:
    Mobile Phone*:
    PLEASE REVIEW CAREFULLY AND ACKNOWLEDGE
    The undersigned acknowledges and agrees that:
    1. As photographic and video equipment are frequently used to memorialize and document Eastern Iowa 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 Eastern Iowa Honor Flight program. I hereby release the photographer and Eastern Iowa Honor Flight from all claims and liability relating to said photographs. I hereby give permission for my images captured during an Eastern Iowa Honor Flight activities through video, photo, or other media, to be used solely for the purposes of Eastern Iowa 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 Eastern Iowa Honor Flight does NOT provide medical care. I understand that I accept all risks associated with travel and other Eastern Iowa Honor Flight activities and will not hold Eastern Iowa Honor Flight responsible for any injuries incurred by me while participating in the Eastern Iowa Honor Flight program.

    If you agree with our terms make sure you accept them by checking the box

    I accept these terms     Date:

    You will be required to physically sign prior to the actual flight date
    Eastern Iowa Honor Flight is an official Hub of the Honor Flight Network, www.eihonorflight.org