RETIREE BIO DINNER PROGRAM QUESTIONNAIRE: Please Note: This information is necessary to properly compose the Dinner Program Bio. Please keep in mind, that you will have an opportunity to stand up and say a few words at the dinner. Please try to keep it short, and please, please do not use this time as a forum to vent your displeasure with any particular person or group. This is a celebration of your hard work and an evening of fun and laughs. Let’s keep it in that vein. Thank You in advance for your cooperation and enjoy YOUR NIGHT! (All Items in ITALICS With An “ * ” Require An Answer Please) Last Name *: _____________________________ First Name *: _____________________________ Middle Init.: __________ Nickname *: __________________________________________________ Spouse: ______________________________ Spouse’s Nickname: __________________________ Primary Address *: ___________________________________________________________________ City *: _______________________________ State *: ___________ Zip *: ______________________ Telephone *: ________________________ Email *: ________________________________________ Fax: _________________________________ AA Employee Number *: ____________ Retirement Date (actual or planned) *: _________ Please scan & email to [email protected] a selection of 1 to 5 photographs (preferably in normal size) showing you from “back in the day” next to your Bug Smashin’, Early Military, Solo, Tail-Draggin’, Puddle-Jumpin’, Bomb-Droppin’ aircraft... Please indicate if you have a favorite... We will blow-up the best picture into a poster that we think (or that you want) which will get the biggest smiles! The honoree’s posters will be shown in the cocktail area, and the fun is watching the gang try and guess who’s who, while they drink and munch on pre-dinner’s hors d’oeuvres. *I am scanning/emailing # _________ of photographs. If you are a member of The Grey Eagles (or join within 30 days of the dinner) you will receive a retirement plaque from the National Organization. *I would like my Grey Eagles plaque engraved as follows: Captain (F/O) * _________________________________________________________________________ (Waldo A. Pepper; W.A. Pepper; W.A. “Waldo” Pepper; Waldo A. “Wally” Pepper; etc.) Years of Service *: ___________ to ___________ AA YOS *: ____________ to _____________ (Please include your initial companies employment year and/if merger date with American Airlines) NOTE: If you are not now a member of The Grey Eagles but plan to join before the retirement dinner, please fill in the above information. I am a member of the Allied Pilots Association* YES (__) NO (__) If YES, please indicate activities, years of service, and position (i.e. Domicile/National Officer, Committee, etc): ______________________________________________________________________________________
 ______________________________________________________________________________________ Your Biography: Born* (City & State): ________________________________________________________________ Raised City(s) & State(s)*: __________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Military/Combat Time and Locations*: _____________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Other Professional Flying*: ________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Date of Hire by American Airlines (or an airline merged into AA)*: ________________ Please list that Airline*: ___________________________________________________________ Where have you been based*: _____________________________________________________ _____________________________________________________________________________________ What equipment have you flown for AA (or merged carrier)*: _____________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ If you know them, please list the specifics of your last trip: Flight # ______________ Date _______________ From ____________ To ____________ Type Equipment ______________ Cockpit Crew ___________________________________ ____________________________________________________________________________________ Relatives and Friends Aboard (include all of them: Spouse/Kids/Grand-Kids/etc.): ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ What are your Retirement Plans (travel, work, hobbies, etc.)* ____________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ High School (name/location)* _____________________________________________________ College(s) (name/location)* _______________________________________________________ ____________________________________________________________________________________ First Solo (Military or Civilian)--Where/When/Type Aircraft*: ______________________ _____________________________________________________________________________________ Civilian Aviation Training--Where/When/Type Aircraft*: ___________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Military (Branch of Service)*: ______________________________________________________ Dates of Service (list Guard and Reserves separately)*: ___________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Military Pilot Training (locations and dates)*: _____________________________________
 ____________________________________________________________________________________ ____________________________________________________________________________________ Military Type(s) of aircraft flown and where*: ____________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ Any Additional Info/Thoughts/Ideas?!?: __________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Tell Us About Your Most Favorite and/or Most Memorable Trip*: ________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Thank You for sharing the trip down memory lane...