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Application for Admission
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First Name:
 
Middle Initial or Name:
 
Last Name:
 
Address:
 
City:
 
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Zip:
   
Phone:
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Program or Helicopter Ratings Sought:
 
Date of Birth (MM/DD/YYYY):
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City of Birth:
 
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Country of Citizenship:
 
Anticipated Training Start Date (MM/YYYY):
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Gender:
 
Are You a High School Graduate or GED?
College Training or Degree(s)
If Yes, List Training and/or Degree(s):
Prior Aviation Experience (or Ratings) if any:
Personal/Medical Questions (to be kept confidential)

Note: There are very few medical conditions that will prevent you from obtaining an FAA Medical Certificate
Are You Prone to Motion Sickness?
If You Wear Glasses or Contacts, if Your Vision Correctible to 20/20?
Are You Presently Under a Doctor's Care for any Condition?
Are You Presently Taking Any Prescription Medication?
Are You Ever Failed a Color Blindness Test?
Bad Driving Record or DUI/DWI's?
Any Felony Convictions?
If you have (or have ever had) any of the conditions listed below, it might (or might not) prevent you from obtaining an FAA Medical Certificate. If so, you should discuss these matters confidentially with the Chief Pilot before beginning training.

Heart Disease/Heart Attack; High Blood Pressure; Tuberculosis or other Lung Disease(s); Severe Allergies; Asthma; Diabetes; Cancer; Hearing Loss; Frequent Headaches; Dizziness; Fainting Spells; Convulsions; Epilepsy; Ulcers; Amputations of any body part; Psychiatric Treatment.