TRAVEL DONATION FORM

Please use the following form to donate your Frequent Flyer and Travel Mile Points. We will contact you via telephone within four business days at the latest.

If you would like to donate miles or points from more than one Airline, Hotel or Company -- Please hit your back button to return and modify your information, resubmitting upon completion, repeating the process until you have printed forms for all miles/points you intend to donate. Please print each resulting form before continuing to another.

If you have any questions you would like answered previous to initiating the donation process, please contact us instead of using this form. Or, if you prefer to speak with a customer service representative, please feel free to call us at 1-502-292-2456 seven days a week. Our [ PRIVACY POLICY ]

If you prefer to print from a word document (a blank copy of what this form input produces) -- Please select the following link:

VAA FREQUENT TRAVEL MILE/POINT DONATION FORM

ALL FIELDS ARE REQUIRED

FIRST NAME
LAST NAME
ADDRESS
APT/SUITE/LOT
CITY
STATE
ZIP CODE
EMAIL ADDRESS
Contact Telephone (Format: 123-456-7890)
Alternate Telephone (Format: 123-456-7890)
The Charity to Receive the Proceeds of this Donation is Victims Assistance of America, Inc. (VAA)
AIRLINE HOTEL or COMPANY
NUMBER OF MILES OR POINTS YOU ARE DONATING
MY TRAVEL ACCOUNT NUMBER
MY TRAVEL ACCOUNT PIN
SPECIAL INSTRUCTIONS OR OTHER COMMENTS

Upon submission, please print the Travel Donation Form. Instructions are on the form with specifics on how to FAX, Mail or Email your Travel Mile Donation Form back to VAA for processing.

Please select the link (www.victimsassistanceofamerica.org) at the bottom of your form to return to the VAA website. You will receive an unofficial copy of your offered donation via email shortly after your submission.

VAA appreciates your donation. Thank You!

If you have any difficulty with this form or wish to speak with a customer service representative, please call us at 1-502-292-2456.