No Service Member Spends The Holidays Alone Campaign

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Which Program are you applying for?

If applying for yourself:*

How does the Service Member or Veteran plan to celebrate the holidays?*

Explain the circumstances or incident that caused the injury/illness.*

Service Member or Veteran Information:

Please let us know about the Hero requesting assistance, and a little about their service.

Gender*

What is the service member’s gender?

Race*

What is the service member’s race?

Branch of Service*

Please provide the Service Member’s branch of service.

Rank*

Title*

Service Member's Current Military Status*

Please provide the Service Member’s current status.

Duty Location (if active duty):

Mobile Phone*

Please type and do not copy and paste.

Alternate Phone

Please type and do not copy and paste.

Email*

Validation of Medical Treatment

As part of the approval process, Luke’s Wings requires verification of treatment.

Current Treatment Facility

Current Medical Provider/Medical Case Manager Title

Current Medical Provider/Medical Case Manager Phone Number*

Please type and do not copy and paste.

Current Medical Provider/Medical Case Manager Email

Medical Diagnosis of Injury/Illness (Attach proof of service-connection)*

Max. file size: 128 MB.

Describe Recovery Program:*

This request is*

Length of time for recovery program*

Passenger Information:

For verification purposes, please provide the passenger’s full name as shown on license or other appropriate legal documentation.

# of Passengers*

For more than 6 passengers, please contact us here.

First Passenger Details

First Passenger Relation to Service Member or Veteran*

First Passenger Gender:*

First Passenger Email:*

First Passenger Phone:*

Please type and do not copy and paste.

First Passenger Known Traveler Number (if applicable):

Second Passenger Details

Second Passenger Relation to Service Member or Veteran*

Second Passenger Gender:*

Second Passenger Email:*

Second Passenger Phone:*

Please type and do not copy and paste.

Second Passenger Known Traveler Number (if applicable):

Third Passenger Details

Third Passenger Relation to Service Member or Veteran*

Third Passenger Gender:*

Third Passenger Email:*

Third Passenger Phone:*

Please type and do not copy and paste.

Third Passenger Known Traveler Number (if applicable):

Fourth Passenger Details

Fourth Passenger Relation to Service Member or Veteran*

Fourth Passenger Gender:*

Fourth Passenger Email*

Fourth Passenger Phone:*

Please type and do not copy and paste.

Fourth Passenger Known Traveler Number (if applicable):

Fifth Passenger Details

Fifth Passenger Relation to Service Member or Veteran*

Fifth Passenger Gender:*

Fifth Passenger Email*

Fifth Passenger Phone:*

Please type and do not copy and paste.

Fifth Passenger Known Traveler Number (if applicable):

Sixth Passenger Details

Sixth Passenger Relation to Service Member or Veteran*

Sixth Passenger Gender:*

Sixth Passenger Email*

Sixth Passenger Phone:*

Please type and do not copy and paste.

Sixth Passenger Known Traveler Number (if applicable):

Travel Details

Departure Airport:*

Arrival Airport:*

Specific Travel Accommodations (if applicable):

Form Submission

Please ensure all the previous form fields are populated to the best of your ability. Then, press ‘submit’ below.

Request A Flight

This campaign is designed to ensure that no recovering service member or Veteran spends the holidays alone by reuniting them with loved ones through provided travel, recognizing the vital role family plays in healing and well-being.

Service Member or Veteran Information:

Validation of Medical Treatment

Passenger Information:

First Passenger Details

Second Passenger Details

Third Passenger Details

Fourth Passenger Details

Fifth Passenger Details

Sixth Passenger Details

Travel Details

Form Submission

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No Service Member Spends The Holidays Alone Campaign

Request A Flight

This campaign is designed to ensure that no recovering service member or Veteran spends the holidays alone by reuniting them with loved ones through provided travel, recognizing the vital role family plays in healing and well-being.

Service Member or Veteran Information:

Validation of Medical Treatment

Passenger Information:

First Passenger Details

Second Passenger Details

Third Passenger Details

Fourth Passenger Details

Fifth Passenger Details

Sixth Passenger Details

Travel Details

Form Submission

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Reunite A Wounded Service Member

Contact Us

Media Kit & Logo

Terms & Privacy Policy

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