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Admission Form


Transferee
New
Others:
Mailing Address:
Name:
Sex:
Male  Female
Date of Birth:
Marital Status:
Place of Birth:
Nationality:
Age:
Complexion:
Mobile Number:
Telephone Number:
Weight:
Height:
Built:
Passport Number:
Distinguishing Mark/s:
Relationship:
Nearest Relative:
Address:
Course:
Highest Educational Attainment:
Address:
Name of School:
License Number:
License Held:
Rating:
Issuing Authority:
Medical Examiner:
Last Medical Examination:
Finding/s:
Name of Hospital/Clinic:
Private Pilot Ground Training
Course to be taken from us:
Private Pilot Flight Training
Commercial Pilot Flight Training
Commercial Pilot Ground Training
Commercial Pilot Ground Training
with instrument rating
Other/s:
Flight Instructor's Course
If Yes, specify inclusion:
Are you availing the package deal?
Yes  No
If Yes, please specify:
Have you ever convicted of
any crime involving moral turpitude?
Yes  No
If Yes, please specify:
Have you ever been penalized of any
infraction of the Civil Air regulations?
Yes  No
Verified By:
Date Filed:
Action Taken:
Date:
Signature: