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INSTRUCTOR
Mr. JUSTIN JOHNSON
Commercial Single-Engine, Multi-Engine
Instrument Rated Pilot
Aviation Ground Instructor (AGI,IGI)
Application Form
1. STUDENT INFORMATION
Full Name
*
Full Name
First Name
First Name
Last Name
Last Name
Date of Birth
*
Gender
Male
Female
Prefer Not To Say
Phone Number
*
Email
*
Nationality
Address
Emergency Contact Name
*
Relationship To You
Phone Number
*
2. COURSE INFORMATION
Please Select The Course You Are Applying For
*
Private Pilot Ground School
Instrument Rating Ground School
Commercial Pilot Ground School
Have You Received Any Previous Aviation Training
*
Yes
No
If Yes, Please Provide Details
*
3. CLASS SCHEDULE PREFERENCE
Please Select Your Preferred 3 Class Days
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preferred Class Time
*
Morning (8:00 AM - 12:00 PM)
Afternoon (12:00 PM - 4:00 PM)
Evening (5:00 PM - 9:00 PM)
Preferred Start Date
*
Class Schedules Are Subject To Availability
4. EDUCATIONAL BACKGROUND
Highest Level of Education Completed
*
High School
Associate Degree
Bachelor's Degree
Master's Degree
School/Institution Attended (Type "N/A" If None)
*
5. MEDICAL INFORMATION
Do You Currently Hold An Aviation Medical Certificate?
*
Yes
No
If Yes, Specify Class
*
First Class
Second Class
Third Class
Certificate Expiration Date
*
6. STUDENT COMMITMENT
I understand that successful completion of this course requires attendance, participation, and personal study. I agree to abide by the policies and procedures established by Top Flight Learning Institute.
Do You Agree With The Student Commitment Section?
*
Yes
No
Your Initials
*
Agreement Date
*
SUBMIT APPLICATION
If you are human, leave this field blank.