Form: Elementary Juvenile Form | Eagles Assurgent Connexion

Applicant Information

Fields marked * are required

Educational Background

Current Grade/Year *

Parent/Guardian Information

Full Name of Parent/Guardian *

Relationship to Applicant (e.g. Parents, Guardian) *

Program Details

The Juvenile Aviator Program for elementary students is an eight-week program introducing aviation concepts through interactive and engaging activities.

Preferred Mode of Training: *

AudioVisual

On-site

Location (if On-site):

Does the applicant have any allergies, medical conditions, or special needs we should be aware of? *

Yes

If Yes, please specify

How Did You Hear About Us? *

Social Media

Website

Referral

Other (specify)

Acknowledgment and Declaration

I, the undersigned parent/guardian, certify that the information provided in this form is accurate to the best of my knowledge.

I give permission for my child to participate in the Juvenile Aviator Program organized by Eagles Assurgent Connexion.

I understand and agree to the terms and conditions of the program and acknowledge that Eagles Assurgent Connexion will take all reasonable precautions to ensure my child’s safety during the program activities.

Get in Touch

(+234) 913 680 9848

info@eaglesassurgent.org

Elite Academy Area M, World Bank New Owerri, Imo State.

(+234) 913 680 9848

Applicant Information

Educational Background

Parent/Guardian Information

Residential Address

Program Details

Our Services

Company