Flight Training Enrollment Form

Last Name (Surname / Family Name):
First Name:
Middle Name:
E-mail:
Telephone:
Please call me directly: Yes No
Best time to call me: Morning Evening
Address:
City, State/Province, Postal Code: ,
Country:
Do you require an M1 student visa? Yes No
Date of Birth: (MM/DD/YYYY)
Gender: Male   Female
City of Birth:
Country of Birth:
Country of Citizenship:
Do you hold a current passport: Yes   No
If so, when does your passport expire: (MM/DD/YYYY)
Do you have any dependents coming with you: Yes   No
If yes, list Last name, First name, Middle name,
Suffix, Date of Birth, country of Citizenship,
Gender, Relationship.

This must be done for each dependant:
Click on all courses you wish to
enroll on:

For specific courses or training
requirements & prices not listed please
email fly@aviationpacific.com
Private
Instrument
Commercial Single
Commercial Multi
Indonesian Airline Cadet Program (Complete Course)
Desired Start Date: (MM/DD/YYYY)
Can you read and speak English: Yes   No
Are you able to pass an FAA medical exam: Yes   No
Have you ever had an FAA medical exam: Yes   No
Which type of accommodation would you
prefer:
Hotel   Family Homestay
Please list two emergency contact names,
phone numbers and addresses:
Highest level of education completed:
Do you have any flight time,
hold any flight certificates or
have any Military experience?
Were you referred to us, if so what
method or by which organization :
ENROLLMENT PAYMENT DETAILS

Due to the level of administration needed to enroll a student and issue the appropriate documentation to obtain a study M1 visa (I20) & TSA clearance we now require a $500 deposit. This deposit is non-refundable and must be received no later than 30 days before any documentation is dispatched.

STUDENTS ON THE INDONESIAN AIRLINE CADET PROGRAM MUST COMPLETE THIS FORM, HOWEVER PLEASE PRESS THE ENROLL WITH BANK TRANSFER BUTTON THEN CLOSE THE PAYMENT PAGE WITHOUT MAKING A PAYMENT THEN NOTIFY development@airlinespilotschool.com

Course deposit will then be coordinated by airlinespilotschool.

Aviation Pacific Inc are authorized by the United States Department of Homeland Security (formerly known as INS) to enroll non-immigrant students and are M1/TSA Visa approved. www.aviationpacific.com skype: aviationpacific