Dispatch Release Form

First Name *

Last Name *

Email *

Phone *

Preferred Contact Method *

Phone

Text Message

What do you want to do in aviation? *

Career/Commercial Pilot

Recreational Flying

Fly For Business

Own My Own Airplane

What license/rating are you interested in pursuing?

Select all that apply.

Have you ever been in a small plane before? *

Yes

Is the Discovery Flight a Gift? *

Yes

If "yes" to previous, does that person want to pursue flight training? *

Yes

Unsure

How many lessons per week could you do on average? *

0-1

1-2

2-3

Unsure

When would you like your discovery flight and training to begin? (Schedule Permitting) *

ASAP

1-3 Weeks

1-3 Months

Please leave any questions in the following box.

First Name *

Last Name *

Phone Number *

Email *

Date of Birth *

Current Occupation *

Home Address line 1 *

Home Address line 2 *

City *

State *

Zipcode *

Country *

Do you have a drivers license? If so, you will be asked to upload it at the end. *

Yes

Country of Citizenship *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Do you have an FAA pilot certificate? *

Yes

If so, what certificate? *

Category, class, and any ratings. Select all that apply.

Certificate Issue Date *

Certificate Number *

Do you hold a CFI? *

Yes

Medical Issue Date *

Current Flight Time *

C172 Flight Time *

C182 Flight Time *

DA40 Flight Time *

Last 12 Months *

Have you ever had any violations, incidents, or accidents? *

Yes

Passport *

Maximum file size: 4 GB

Drivers License *

Maximum file size: 4 GB

Birth Certificate *

Maximum file size: 4 GB

Current Logbook Totals *

Maximum file size: 4 GB

Medical Certificate *

Maximum file size: 4 GB

FAA Certificate if you have one. *

Maximum file size: 4 GB

I agree that all of the information provided above is accurate. I agree to the club rules and rental procedures stated above. I authorize MyFlight to process my application and charge my card a one-time non-refundable activation fee of $225 for Basic or $250 for Premium. I authorize my card on file to be saved for membership dues of $85 billed monthly for Basic or $250 billed monthly for Premium.

I agree and submit application for review

First Name *

Last Name *

Phone Number *

Email *

Date of Birth *

Current Occupation *

Home Address line 1 *

Home Address line 2

City *

State *

Zipcode *

Country *

Do you have a drivers license? If so, you will be asked to upload it at the end. *

Yes

Country of Citizenship *

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Number *

Do you have an FAA pilot certificate? *

Yes

If so, what certificate?

Category, class, and any ratings. Select all that apply.

Certificate Issue Date *

Certificate Number *

Do you hold a CFI? *

Yes

Medical Issue Date

Current Flight Time *

DA20 Flight Time *

DA42 Flight Time *

DA40 Flight Time *

Last 12 Months *

Have you ever had any violations, incidents, or accidents? *

Yes

Passport *

Maximum file size: 4 GB

Drivers License *

Maximum file size: 4 GB

Birth Certificate

Maximum file size: 4 GB

Current Logbook Totals

Maximum file size: 4 GB

Medical Certificate

Maximum file size: 4 GB

FAA Certificate if you have one.

Maximum file size: 4 GB

I agree and submit application for review

Dispatch Release

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