CFI Application - Step 1 Pilot Information | Flight Information | CFI Qualifications | Insurance Information
		Please fill out this form if you are applying for CFI flight privileges with AvInstruction. If you are a STUDENT or LICENSED pilot interested in flying or training in an AvInstruction registered aircraft, you must complete the Pilot application. All information in red is required. You are on a secure server. Pilot Information First Name M.I. Last Name Address City State ZIP     Phone Number         Additional Phone Number         EMAIL         Date of Birth (00/00/2003)     Driver's License or ID# State Expiration (00/00/00) Qualifying identification is government issued ID with photo. (i.e., Driver's License, State ID, Passport, or Military ID)       Flight Information   FAA License #   Medical Date Class Flight History Please check each rating and/or endorsement certificate(s) held: SEL High Perf. Endorsement Aerobatic MEI High Altitude Endorsement MES CFII Tailwheel Endorsement SES   Total PIC Flight Hours     Total PIC Instrument Actual Hours     Total PIC Multi Hours       Primary Aircraft Type/Make/Model   Secondary Aircraft Type/Make/Model CFI Qualifications / Public Profile Information     Total Dual Instruction Given   CFI Renewal Date     Date you started instructing       Please list each type of aircraft you may instruct in:               Preferred Training Aircraft Type/Make/Model   Secondary Preferred Training Aircraft Type/Make/Model What Certificates do you instruct? Private CFI Aerobatic IFR CFII Seaplane Commercial MEI Tailwheel $     CFI hourly rate     Availability (M-F/9-5 etc.)       Home Airport   Secondary Airport Other Club Memberships           What kind of computer do you have? Desktop or Laptop? Mac PC None   Desktop Laptop None Other           Do you have an email capable cellphone? YES NO     Do you have any additional means of contact for students or pilots? If so, please list/describe here:
		Emergency Contact Information Contact First Name M.I. Contact Last Name Address City State ZIP Phone Number Additional Phone Number      Email address     Relationship
		Aviation Insurance Information     Insured Full Name         Insurance Company Name         Insurance Company Address     City State ZIP     Main Phone       Contact Name   Contact EMAIL     Contact Phone         Policy Number     Insurance Date Start Insurance Expiration Coverage Amount - Hull Coverage Amount - Liability     Deductible Amount
		Billing Information   Cardholder Name     Card Billing Address Card Billing City State ZIP Phone Number EMAIL