Name 
	Company 
	Phone 
	Email 
	Num. of Aircraft in Fleet 
	
	Send us a quick message or fill in the optional boxes below: 
	
	Aircraft Make 
	Aircraft Model 
	Registration Number 
	
	Hours Flown 
	
per month 
per year 
 
	    
	Do you fly or intent to fly internationally? 
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Yes 
No 
 
	Additional Information 
	
	Do you fly or plan to fly polar routes? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you need or have AFIS/ACARS? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you need or have VHF AFIS? SAT AFIS? Not Sure? 
-- Select an Option -- 
Yes 
No 
Not Sure 
 
	Additional Information 
		
	Do you have or need FANS 1/A service? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you want or have voice communications for the cockpit? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you want or have voice communications for the passengers? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you want of have satellite connectivity with EFB's (Electronic Flight Bags)? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	Do you want or have Internet connectivity for passengers? 
-- Select an Option -- 
Yes 
No 
 
	Additional Information 
	
	If you know the make and model of the Satcom system, installed now or that will be installed, please list them here: 
	
	Any additional information that will help us quote Satcom Service or Hardware?