2010 Service Feedback Form


The results of this form will be sent to the MEC Air Safety & Health Chairs & Service Subcommittee Chair, who will contact you for more information if needed.


1) First Name
2) Last Name
3) Email Address:
4) Clock or Employee ID:
5) Where Are You Based?
6) Best contact - phone/email:
7) Date of Issue/Incident:
8) Aircraft Type?
9) FLIGHT ATTENDANT'S STATEMENT OF ISSUE: (Please be as specific as possible. Include dates and times of incident/issue, names, witnesses, etc..)
10) Did you injure yourself or a passenger (not required)? If so, please state what happened and the nature of the injury:
11) Your Digital Signature: