Nomination Form

Participating Organisations may use this form to nominate children who they wish to enrol on one of our entirely free flight programmes. This Form may also be used by any Person who wishes to nominate a sick child to any one of the programmes.

For determing the Priority Group (optional) and give the correct answers to the 3 value based filters found at the end of this Form please refer to the Prioritisation Methodology Document. Given the high demand for our programmes and the limited spaces available children who rank high on the Priority Group will be given precedence over children with a lower or no priority rating.

Parents or other persons who wish to nominate a child who is suffering from a serious illness please choose ‘Other’ when making a selection under the ‘Entity or Person making the Nomination” section.

Entity or Person making the Nomination

Name of the child you are nominating

The child’s age

Residential Location

The name of the accompanying parent or guardian

The telephone number of the parent or guardian

Select the flight programme

Please write a short explanation to tell us why you are nominating this child

Life Filter

Term Filter

Benefit Filter