Mileage Donation Form

Mileage Donation Preference:

• Air Charity Network® (formerly Angel Flight America)

  Medical air transportation for terminally ill patients in financial need

• American Red Cross

  Transports disaster relief workers

• Fisher House Foundation

  Helping to Reunite Wounded Service Members with their Families

• Make-A-Wish Foundation

  Fulfills travel wishes for children with life-threatening illnesses

First Name:

M.I.:

Last Name:

Street Address:

City:

State:

Zip Code:

E-Mail Address:

US Airways reserves the right to allocate miles between charities within the guidelines of the Miles of Hope® program.