Online applications | AIR - TRANSPORT EUROPE, spol. s r.o.

The main donor must be 18 years and over. The child must be under 18 years old.

All fields marked with * are required.

Contact details – first donor

Title

Name *

Surname *

Date of birth *

Street *

ZIP *

City *

Region

Country *

Phone

E-mail *

How did you hear about the donor card?

Contact details – second donor

Title

Name *

Surname *

Date of birth *

E-mail

Children

Name *

Surname *

Date of birth *

Consent to the processing of personal data

I agree to manage, process and store personal data for the Donor Card Helicopter Emergency Medical Service program. *

Payment

Payment method *

Amount *

Validity period *

Visa

Visa Electron

MasterCard

Maestro

Discover