Form: Secondary Juvenile Form | Eagles Assurgent Connexion

Fields marked * are required

Residential Address *

Current Grade/Year *

Full Name of Parent/Guardian *

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

Preferred Training Schedule: *

Self-Ground School Study

Virtual Ground School Instruction

Onsite Ground School Instruction

Preferred Session Month *

How did you hear about the Secondary Juvenile Aviator Program? *

Online (Website/Social Media)

School Referral

Family/Friends

Other (specify)

Why are you interested in aviation? *

What are your career goals or aspirations? *

Do you have any previous aviation-related experience? If yes, please specify (e.g., drone flying, aviation events, etc.)

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

Yes

If Yes, please specify

Acknowledgment and Declaration

I hereby declare that all the information provided in this form is true and accurate to the best of my knowledge.

I understand that acceptance into the program is subject to availability and meeting the program’s requirements.

I consent to the use of my/my child’s information for registration and communication purposes related to the program.