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Flight Application

Step 1 of 6

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Your Information

For the fields below, please information about yourself, not the passenger (unless you are the passenger).
Your Name(Required)
How did you hear about us?

Passenger Information

For the fields below, please enter information about the passenger who would be flying with us.
Passenger Name(Required)
Passenger Address(Required)
MM slash DD slash YYYY
Please enter in feet and inches. (ex. 6'2").
Please enter the passenger's weight in US pounds. Pilots require this information in order to calculate fuel for the flight.
Ability to Move(Required)
Choose the highest level of mobility which is safe for this person.

Emergency Contacts

At least one emergency contact is required.
Emergency Contact 1(Required)
Emergency Contact 2

Flight Information

MM slash DD slash YYYY
MM slash DD slash YYYY
In order to quality, you must have a departure location or destination within Michigan, Wisconsin, Indiana, Illinois, or Ohio
In order to quality, you must have a medical need for long distance transportation East of the Rocky Mountains.

Flight Companion Information

Wings of Mercy requires that you have a companion fly with you.
Name(Required)
Address(Required)
Please enter in feet and inches. (Ex. 6'2")
Please enter the flight companion's weight in US pounds. Pilots require this information in order to calculate fuel for the flight.

Form Completion

By signing below, I affirm that I have read all forms and am aware of restrictions and limitations of a Wings of Mercy flights. I also understand that Wings of Mercy may use photos from flight, and I may call or write to request to opt out of photos.
Clear Signature
This field is for validation purposes and should be left unchanged.

News & Events

  • 29th Annual Muskegon CareAffaire
  • Run for Wings 5K 2025
  • TVC 5K Run the Runway 2025
  • God’s plan coming full circle.
  • Free Flights Mean a Better Life

Contact Us

Wings of Mercy, Inc.
100 South Pine Street, Suite #393
Zeeland, MI 49464

p: 616.396.1077
f: 616.748.6093

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