Contract Pilot Registration |
|
|
| One Year: $120.00 Six Months: $69.00 |
|
|
Promotional Code: (if applicable) |
|
|
| * |
First Name: |
|
| * |
Last Name: |
|
|
| * |
Address (Line 1): |
|
| |
Address (Line 2): |
|
| * |
City: |
|
| * |
State: |
|
| * |
Zip Code: |
|
|
| * |
Phone Number: |
|
| |
Fax Number: |
|
| * |
Email Address: |
|
|
| * |
Airports Served: |
|
|
| |
Type of Services Provided: |
|
| |
|
|
| |
|
|
| |
Pilot employment during the past 12 months?: |
|
|
| Flight Experience |
|
|
|
|
| * |
Medical Class and Date: |
|
| * |
Type Ratings Held: |
|
| * |
Total Flight Hours: |
|
| * |
Turbojet Hours: |
|
| * |
Turboprop Hours: |
|
| * |
Multiengine Hours: |
|
| * |
Instrument Hours: |
|
|
| Aircraft Information |
|
| Primary Corporate Aircraft Providing Service In (make & model): |
| |
|
| * |
Total Hours in this Aircraft: |
|
| * |
Last Training Date for this Aircraft: |
|
| * |
Type of Training Received: |
|
| * |
Training Received From: |
i.e. Simuflite/Flightsafety |
|
| Second Corporate Aircraft Providing Service In (make & model): |
| |
|
| * |
Total Hours in this Aircraft: |
|
| * |
Last Training Date for this Aircraft: |
|
| * |
Type of Training Received: |
|
| * |
Training Received From: |
i.e. Simuflite/Flightsafety |
|
| Third Corporate Aircraft Providing Service In (make & model): |
| |
|
| * |
Total Hours in this Aircraft: |
|
| * |
Last Training Date for this Aircraft: |
|
| * |
Type of Training Received: |
|
| * |
Training Received From: |
i.e. Simuflite/Flightsafety |
|
|
|
