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Name*

First Last

Please use your exact name as reflected on your Passport

Airline, Sales Agent or official Partner Representative*

If you are part of an Airline or have use one of our exclusive partners or agents to enroll, please provide the name or use NA.

Program Interested*

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Country Code*

Mobile Phone*

Email*

Gender

Male

Female

Date of Birth

MM slash DD slash YYYY

Place of Birth

Citizenship

Passport Upload (Please scan document do not use photo to upload)*

Max. file size: 50 MB.

Only For Pilots Training in the US, Do you have a valid US visa?

Yes

Only For Pilots Training in the US If yes, please specify type of Visa

Visa Upload (Please scan document do not use photo to upload)

Max. file size: 50 MB.

Pilot License Held*

Upload Pilot License Held (Please scan document do not use photo to upload)

Max. file size: 50 MB.

Pilot License Certificate Number #*

Front License Upload (Please scan document do not use photo to upload)*

Max. file size: 50 MB.

Back License Upload*

Max. file size: 50 MB.

Additional Licenses

Accepted file types: iejpg, gif, png, pdf, Max. file size: 50 MB.

If you are applying for an FAA certificate, please upload all your existing licenses, foreign or FAA Private/Comercial

Last 3 Pages of Log Book (Please scan document do not use photo to upload)

Drop files here or

Max. file size: 50 MB.

Medical Upload

Drop files here or

Max. file size: 50 MB.

Medical Class/EXPIRATION DATE

Professional Curriculum Vitae*

Max. file size: 50 MB.

The Professional Curriculum is a document that summarizes your work history, education, and skills. The main purpose of a CV is to know your experience better so we are able to give you a more customize service.

3. Flight Hours Multi- Engine Turbo Jet Time (SIC, PIC):*

Total Time on Aircaft*

Please specify total time on aircraft, this only applies for program and aircrafts at our academy if you have time on different aircrafts you do not need to state them here, if you do no not have any time please use 0

Hrs*

Total time as PIC*

Total time as SIC*

Only for FAA Programs: Verification Letter from FAA

Max. file size: 50 MB.

***If you have a Foreign License and you are taking an Initial/ Type Rating or any course approved by FAA that requires a verification Letter, please provide this document.

Cancelation

Notice of cancellation, must be received in writing at our office 45 days prior to class start date. Immediately, upon REFUND POLICY notification of cancellation Alliance Aviation will refund deposit. An amount of $200.00 will be used to cover administrative fees. Failure to cancel prior to 45 days from the start date will result in forfeit of entire deposit.

WIRE INSTRUCTIONS BANK NAME: TRUIST Account: Alliance Aviation, Inc. ABA routing: 053101121 Account number: 1100021508118 Swift: BRBTUS33 Bank Address: 520 Crandon Blvd, Key Biscayne, FL 33149 Physical Address: 1470 Lee Wagner Blvd Fort Lauderdale FL 33315 ***Please reference customer name and/or payment information***

I agree to the terms of service

Digital signature

BY SIGNING I CERTIFY THE INFORMATION ABOVE OF IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.

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