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First Name
Last Name
Email
Phone
Address
City
State AL - AlabamaAK - AlaskaAZ - ArizonaAR - ArkansasCA - CaliforniaCO - ColoradoCT - ConnecticutDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiID - IdahoIL - IllinoisIN - IndianaIA - IowaKS - KansasKY - KentuckyLA - LouisianaME - MaineMD - MarylandMA - MassachusettsMI - MichiganMN - MinnesotaMS - MississippiMO - MissouriMT - MontanaNE - NebraskaNV - NevadaNH - New HampshireNJ - New JerseyNM - New MexicoNY - New YorkNC - North CarolinaND - North DakotaOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVT - VermontVA - VirginiaWA - WashingtonWV - West VirginiaWI - WisconsinWY - Wyoming
Zipcode
Are you 18+ Years Old? (Applicants under 18 require parent contact) YesNo
[group age-18-no]
Parent First Name
Parent Last Name
Parent Email
Parent Phone
[/group]
Number of Flights: Total hours: Solo: Date and Location of first flight: Types of Aircraft: Other flying experiences?
SSA Member? YesNo Club Associations: Explain your participation in any soaring/ground-related activities: List aviation memberships:
Schools attended, City, State: School/High School GPA: Graduated? YesNo Date of Graduation: College/University GPA: Date of College/University Graduation: List all academic achievements (honors, awards, scholarships, advanced placement): Please attach most recent transcripts to this application.
School/Church/Clubs/Groups: Community service: Sports: Other hobbies or interests: Detail your interest in flight, what encouraged you to fly, and what is it that you can offer the field of aviation in the future: Explain your financial need to begin or continue soaring: Please indicate that you certify that the information provided is true. Yes