Giffords Courage Fellows June 2022 Fly-In

June 6 – 8, 2022 / Washington, DC

Please complete this form to submit your flight preferences and TSA information to our travel agency partner, Connoisseur Travel. You will be contacted by an advisor within 24 business hours to confirm your itinerary. Flights will not be ticketed without your review and approval.
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Program Affiliation*
Traveler Information
Please enter your legal name and other information below exactly as shown on the government-issued ID you will be traveling with (i.e. passport, driver's license, etc.).
First Name*
Middle Name
Last Name*
Gender*
Please list your gender as listed on your government issued ID.
Date of Birth (MM/DD/YYYY)*
Email Address*
Cell Phone Number*
Known Traveler Number (KTN)
Loyalty / Frequent Flier Number(s)
Guardian / Travel Arranger Information
If you are under 18, we require the name of a guardian to be provided in order to secure your flights.
Are you under the age of 18?*
- Yes
- No
Guardian Name*
Guardian Email Address*
Guardian Phone Number*
Air
From
To
Departure Date (MM/DD/YYYY)
Flights should arrive in to Washington, DC (DCA) by noon on Monday, June 6, 2022.
Preferred Departure Time
Return Date (MM/DD/YYYY)
Flights should depart Washington, DC (DCA) after 2pm on Wednesday, June 8, 2022.
Preferred Return Time
Seat Preference
Additional Information
Please share any additional air travel related notes here:

Traveler Information