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Online PVD 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 2013
Your Telephone Number
Your eMail Address
Number of PVDs 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
Donate to a Specific Flight Attendant -Select- NO YES
If YES! Type 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
I Authorize Wings to use this donation of PVDs for other Flight Attendants on the PVD program as needed (check one)
(check box) to complete donation & agree I state that the information given is correct I Authorize this PVD Donation