Vx Initial Course Enrollment Application; Private Pilot, Instrument, Commercial, or Multiengine

Vx Initial Course Enrollment Application

I Agree

I certify that I am either the Applicant or the Legal Guardian of the Applicant.

Please select who will be taking flying lessons...

Adult Minor

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Language Requirement (14 CFR 61.83 & 61.103)

Can the Applicant read, write, speak, and understand the English language?*

Yes

First Adult Applicant's Name

First Name*

Middle Name

Last Name*

Phone*

First Adult Applicant's Age Acknowledgment*

First Adult Applicant's Date of Birth*

I certify that I am 18 years of age or older

First Adult Applicant's Signature*

Type Signature

Draw Signature

Click to Sign

Parent or Guardian's Email Address

Email*

Confirm Email*

Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

United States Military Status of Applicant

No Military Service

Previously Served

Currently Serving

I'd rather not say.

Course Requested

Select the course you would like to start out with. Don't worry, we can change or add selections later!*

Initial Training/Private Pilot

Instrument Rating

Commercial Pilot

CFI Initial

CFII

Tailwheel

Other

Additional notes about your requested training:

TSA Requirement: Citizenship Status Verification (49 CFR 1552.3)

Is the Applicant a US citizen or national?*

Yes

If yes, please upload one of the following options:

( For more details see 49 CFR 1552.3.)

1. A current, unexpired, US Passport

2. An original or government issued birth certificate WITH a government issued photo ID

3. Original United States naturalization certificate with raised seal, or a Certificate of Naturalization issued by the U.S. Citizenship and Immigration Services (USCIS) or the U.S. Immigration and Naturalization Service (INS) (Form N-550 or Form N-570), together with a government-issued picture identification of the individual;

4. Original certification of birth abroad with raised seal, U.S. Department of State Form FS-545, or U.S. Department of State Form DS-1350, together with a government-issued picture identification of the individual;

5. Original certificate of United States citizenship with raised seal, a Certificate of United States Citizenship issued by the USCIS or INS (Form N-560 or Form N-561), or a Certificate of Repatriation issued by the USCIS or INS (Form N-581), together with a government-issued picture identification of the individual; or

6. In the case of flight training provided to a Federal employee (including military personnel) pursuant to a contract between a Federal agency and a flight school, the agency's written certification as to its employee's United States citizenship or nationality, together with the employee's government-issued credentials or other Federally-issued picture identification.

Note: Your personal information will be kept private and protected behind some of the most secure encryption and data redundancy in the world. We will never share your information with any 3rd party without your prior consent. More security information available on request.

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Thank you for enrolling! One of our personnel will contact you shortly to get you on the schedule!

Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.

By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.

Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*

Parent or Guardian's Age Acknowledgment*

Parent or Guardian's Date of Birth*

I certify that I am 18 years of age or older

Parent or Guardian's Signature*

Type Signature

Draw Signature

Click to Sign

Electronic Signature Consent*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.

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Agree To This Document