Flight Attendant Disaster Relief

Flight Attendant Disaster Relief

INQUIRY FORM
Please Note: Financial crisis will not be considered due to work disruptions caused by labor actions.
Type of Disaster:*
Name of Disaster, if applicable:
Ex. Hurricane Andrew, etc.
Your Full Name:*
Employee Number:*
Base:*
Have you been previously assisted by Wings?*

YesNo
Approximate Date of Assistance*

MonthDayYear
Contact Information
Email*
example@example.com
Best Telephone Contact Number:*
Alternate Telephone Contact Number:
Residence Address:*

Street Address

Street Address Line 2

CityState

Zip Code
Residence County:*
Insurance Information
Homeowner's Insurance?*

YesNo
Name of Home Owner's Insurance Company?*
Flood Insurance?*

YesNo
Name of the Flood Insurance Company?*
Insurance Deductible Amount:*
Description of damage/losses to residence:*
Please be as specific as possible.
Upload supporting document(s) here:

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Upload Photo(s)/Video(s) here:

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I, the undersigned, certify that I have read and understand all the information contained in this application. That all the statements and representations made by me in this application including any accompanying forms are true and correct, and that any provided documentation will be verified by Wings Foundation for authenticity.
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Please verify that you are human*
Should be Empty: