Assistance for Disabled Persons - Application form

Please note fields marked_with (*) are required.

Passenger data

* Name
* Surname
* Email
* Phone

Flight information

* Flight number
* Exhaust port / destination
* Date
* Hour

Additional Informatio

* Are you traveling with a companion_?
* Are you traveling with a guide dog?
* Do you have own wheelchair?
WCHR - I can come up / down the stairs but I'm having trouble with moving over long distances. I need a wheelchair
WCHS - I can not come up / down the stairs but I was able to move short distances (for example in the cabin of the plane). I need a wheelchair
WCHC - I can not come up / down the stairs. I need help in moving to / from the aircraft and the aircraft and to sit at a designated place on the plane
BLND - I am blind / visually impaired in need of assistance
DEAF - I am deaf / hard of hearing. I need of assistance
DPNA - I am a person in need of assistance (for example those requiring assistance with Asperger syndrome, Alzheimer's, and other disabled Down's and efficiencies listed above)