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Application

Make an application using the form below

Capital Connect AviationApplication

All the fields marked with an asterisk (*) are required.

PERSONAL DETAILS

First Name *
Middle Name *
Last Name *
Date of Birth *
Gender *
ID/Passport Number *
Country of Citizenship *
Country of Birth *
Postal Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number *
Email Address *

PHYSICAL CONDITION

Height in (cm) e.g. 170 *
Weight in (kg) e.g. 70 *
Hearing Condition *
Eyesight Condition *
If issued with a medical certificate, indicate details:
Class
Date Issued
Any other medical/physical statement

EDUCATION

College/University
Date Attended
Grade Attained
Country
High School *
Date Attended *
Grade Attained *
Country *

AVIATION EXPERIENCE (If any)

Licence Held
Training School Attended
PIC Hours
Dual Hours
Total Flight Time
Other Ratings (Separate with a coma ",")

PROGRAM DESIRED

Course Applied For *
Start Date Desired *

REQUESTS

Would you like us to offer you housing and accommodation suggestions in the area? *
YesNo
State any other requests here
How did you hear about Capital Connect Aviation? *
If other specify here

ATTACHMENTS

ID/Passport/Birth Certificate *
High School Certificate *
Medical Certificate (if any)
Highest Education Certificate
Last Page of Logbook (if any)
Pilot Certificate (if any)
Passport Size Photo *
Any other relevant document

Verification

Please enter any two digits *Example: 12
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