New Client Information

    1. General Information

    A copy of the following is required: Driver’s License and/or Visa, Birth Certificate or Passport, Pilot License, Medical Certificate, TSA.

    Last Name

    First Name

    Middle Name

    Street Address

    City

    State

    Zip Code

    Home Phone #

    Work #

    Cell / Other #

    E-Mail Address

    Emergency Contact

    Phone #

    Driver’s License #

    State

    Expiration Date

    Date of Birth

    U.S. Citizen?

    If NO, FTSP Approved?

    If NO, what country?

    A copy of your Visa and/or Passport is required.

    2. Pilots Information

    Highest Grade / Certificate Level

    Certificate Number

    Issued

    Ratings and Limitations

    3. Medical Information

    Class

    Issued Date