Guardian Application Form printable pdf download

Last Name:

Date Received:

Guardian Application

Utah Honor Flight would not be successful without the generous support

of our guardians. Guardians play a significant role on every trip, ensuring

that every veteran has a safe and memorable experience. Duties include

physically assisting the veteran at the airport, during the flight and at the

memorials. Guardians are also responsible for their own expenses

(prices will vary depending on travel costs). For further information,

please contact us at 435.272-0254 or

Thank You for your support.

YOUR NAME: ____________________________________________________ NICK NAME: ______________________

(As it appears on your driver’s license or government ID)

(If Applicable)

ADDRESS: ___________________________________________________________________________________________

CITY: ____________________________________________________________ STATE: ______ ZIP: _______________

PHONE: Day: _______________________ Evening: ______________________ Cell Phone: ________________________

E-MAIL ADDRESS: __________________________________________ AGE: ______ DOB: ______________________

OCCUPATION: _______________________________________________________________________________________

TEE SHIRT SIZE: (S, M, L, XL, XXL, XXXL) _______________________ GENDER: ____M ____F

ARE YOU A VETERAN? ____YES ____NO.

If a veteran, please indicate BRANCH of service, and WHEN and

WHERE you served: ____________________________________________________________________________________

1. How did you learn about the Honor Flight organization? _____________________________________________________

2. Why are you volunteering for Honor Flight? ______________________________________________________________

3. Please list any prior volunteer experience: ________________________________________________________________

__________________________________________________________________________________________________

4. Please list one (1) personal reference:

Name: ______________________________________________________ Relationship to applicant: ________________

Address: City/State/Zip: ______________________________________________________________________________

E-Mail Address: _____________________________________________________________________________________

Phone Numbers – Day: _______________________________ Evening: _______________________________

5. Please list one (1) emergency contact:

Name: _______________________________________________________ Relationship to applicant: _______________

Address: City/State/Zip: ______________________________________________________________________________

E-Mail Address: _____________________________________________________________________________________

Phone Numbers – Day: _______________________________ Evening: ________________________________

6. Please identify the city(ies) from which you would be able to fly as a Guardian.

City(ies): __________________________________________________________________________________________

7. Are you requesting to travel with a specific veteran, if possible? ____Yes _____No.

If yes, please name the veteran: (Please note that completed veteran application must be submitted separately)

__________________________________________________________________________________________________

8. Are you able to push a veteran in a wheelchair up a slight incline? _____Yes _____No.

9. Can you lift 100 pounds? _____Yes _____No.

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Guardian Application Form

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