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Fly4Wings Donation Authorization Form
~ Please fill out form completely ~
Your Employee Number
Your Base -Select One- BOS BOSI DCA DCAI DFW IDF LAX LAXI MIA IMA LGA JFK ORD IOR RDU SFO SFOI SLT
Today's Date Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC DAY 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2012
Your Telephone Number
Your eMail Address
Number of trips you wish to Donate -Select- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
Sequence # of trip that you have already flown & are now donating
Sequence# Date Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
Donate to a Specific Flight Attendant -Select- NO YES
If YES! Recipient's Full Name
Recipient's Employee Number
Recipient's Base -Select One- BOS BOSI DCA DCAI DFW IDF LAX LAXI MIA IMA LGA JFK ORD IOR RDU SFO SFOI SLT
Check Box -> I state that the information given is correct. I Authorize this Fly4Wings Donation
