Aviation Academy International

Application Form

( All fields with * are mandatory)

SERIAL NO.

Course Applying For * :

PPL CPL Others

If Other, Specify

Preferred Date of Joining Ground School * :

Upload Photo * :

Name * :

Date of Birth * :

Gender * :

Male Female

Birth Details * :

Religion

Marital Status * :

Married Single

Educational Details (Give 10th, 12th and College Details) :

Name of Schools / Colleges	Year	Subjects	Percentage

*	*	*	*

*	*	*	*

Knowledge and Fluency of Languages : Written/Spoken (Give exam passed, If any)

Read *

Write *

Speak *

Address *

City *

Country *

State *

Country of Citizenship *

Student Contact Details

Landline

Mobile * :

Email ID * :

Alt Email ID :

Whether holding passport (If yes, Give following details)

Passport No :

Issuing Authority :

Date of Issue :

Date of Expiry :

Place of Issue :

Extracurricular Activities

[List any activities and additional information that you think would be helpful in considering you for admission (such as leadership positions, scholarships and awards you have received, athletics, community service, career goals, and other activities). Attach a comprehensive resume if necessary.]

Activity and Years of Participation	Positions Held and Honors Earned

Name * :

Address * :

City * :

Country * :

Zip Code :

Parent/Guardian Contact Details

Landline :

Mobile * :

Fax :

Email ID * :

Aircraft :

Hours Flown :

Dual

Single

Date Last Flown :

Flying Institute/Club :

Academicians. (Give contact details of two teachers/scholars who have knowledge of your qualification and can be contacted for reference)

Name * :

Address * :

State * :

City * :

Country * :

Tel/Mobile * :

Name:

Address :

State :

City :

Country :

Tel/Mobile :

Others (Give contact details of two personnel in your locality, excluding relatives, who know you and can be contacted for reference)

Name * :

Address * :

State * :

City * :

Country * :

Tel/Mobile * :

Name:

Address :

State :

City :

Country :

Tel/Mobile :

(If ward of a serving/retired defence personnel or of an airline employee and wish to avail of scholarship give details)

Name of Parent / Guardian :

Details of employer (Give name of present employer/service arm incase of defence employees) :

Date of Joining Service (If retired defence employee, give service period) :

Appointment / Position Held (In case of retired defence employees give last appointment) :

Family Income (Total yearly emoluments) :

(Please draw the cheque/ bank draft in the name of - AVIATION ACADEMY INTERNATIONAL, payable at Bangalore)

Cheque/Bank Draft No * :

Amount * :

Date * :

Eg:(mm/dd/yyyy)

Drawn On * :

I certify that the information on this application is complete and correct and understand that the submission of false information is grounds for rejection of my application, withdrawal of any offer of acceptance, cancelllation of enrolment, or appropiate displinary actions. I authorise Aviation Academy International to verify the information I have provided. I agree to notify the proper officials of the institution of any changes in the information provided.

Place * :

Date * :

Eg:(mm/dd/yyyy)

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