Please fill out the form completely and send to SJohnson@airmethods.com or fax to 256-828-0162

 

Date: ___________________________________________________________

Event Date: ______________________________________________________

Purpose: _________________________________________________________

Event Time: _______________________________________________________

Requesting Agency / Business_________________________________________

Contact Person Name: _______________________________________________

Address (including City, State, and Zip):

__________________________________________________________________

__________________________________________________________________

Phone #: __________________________________________________________

E-Mail Address: _____________________________________________________

Expected Attendance: ________________________________________________

Latitude / Longitude: _________________________________________________

LZ Information: ______________________________________________________

Contact Person or dept # and Frequency: _________________________________

Is the aircraft needed? ________________________________________________

Comments about PR: _________________________________________________

___________________________________________________________________

___________________________________________________________________

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