Pilot Application - Step 1
		Pilot Information | Flight Information | Flight History | Insurance Information Please fill out this form if you are applying for STUDENT or LICENSED pilot flight privileges with AvInstruction. If you are a CFI interested in giving instruction in an AvInstruction registered aircraft, you must complete the CFI application. All information in red is required. You are on a secure server. Pilot Information   Home Airport: (please select one) SQL PAO RHV           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 Please select your highest rating: Student | Private | IFR | Commercial | CFI | ATP   FAA License # (Student pilots -> use Medical Certificate #)   Medical Date Class Flight History Please check each aircraft type you have logged PIC time in: SEL | MEL | Complex | High Perf. | Tailwheel | Aerobatic  LICENSED PILOTS:     Total PIC Flight Hours     Total PIC Instrument Actual Hours     Total PIC Multi Hours       Primary Aircraft Type/Make/Model   Secondary Aircraft Type/Make/Model        STUDENT PILOTS:     Total Flight Hours         Total Solo Hours         Total Solo X-Country Hours         Total Dual Flight Received   Primary Aircraft Type/Make/Model   Secondary Aircraft Type/Make/Model
		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