Non-US Citizen Student Application Non-US Student Application & Enrollment Certificate If you're ready to register for flight training, fill out this form. Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Email* Home PhoneWork PhoneCell PhoneCountry of Birth*Country of Citizenship*Previous Countries of Citizenship (if any)Gender*MaleFemaleAge*Please enter a value greater than or equal to 0.Date of Birth* mm/dd/yyyyOccupation*Emergency Contact* First Last Emergency Contact Phone*TrainingRequested Training Start Date* mm/dd/yyyyAnticipated Training Completion Date* mm/dd/yyyyI am Enrolling in the Following Course*Select one...Private Pilot (PVT)Instrument Pilot (INST)Commercial Pilot (COM)Multi-Engine Rating (MULTI)Airline Transport Pilot (ATP)Flight Instructor, Airplane (CFI)Flight Instructor, Instrument (CFII)Flight Instructor, Multi-Engine (MEI)Turboprop Introduction (TINTRO)Turboprop Transition (TPROP)High Performance Endoresment (HI_PERF)Complex Airplane Endorsement (CMPX)Garmin 1000 UpgradeRecurrency Training (RECUR)Spin Training (UN_AT)Aerobatics (ACRO)Formation (FORM)Pinch Hitter (PINCH)OtherIf you selected "Other"*How did you hear about Executive Flyers Aviation?*Select one...FriendSearch Engine/GoogleSearch Engine/YahooSearch Engine/BingFacebookTwitterYelpFoursquareYouTubeWalk-InCessna Pilot Center WebsiteAOPAOtherIf you selected "Other"*What Are Your Goals For Training?*Aeronautical ExperiencePrevious Aeronautical ExperienceFAA Licenses Currently Held*Hours of Dual InstructionPlease enter a value greater than or equal to 0.Hours of Solo FlightPlease enter a value greater than or equal to 0.Hours of Dual Cross-CountryPlease enter a value greater than or equal to 0.Hours of Solo Cross-CountryPlease enter a value greater than or equal to 0.Hours of Night FlyingPlease enter a value greater than or equal to 0.Hours of Instrument ExperiencePlease enter a value greater than or equal to 0.Simulated and ActualType of Medical CertificateNoneFirst-ClassSecond-ClassThird-ClassMedical Certificate Expiration Date Biennial Flight Review Expiration Date Previous Flight or Ground Training, If AnyInclude: Name of School, City and StateI am ready to enroll.*NoYesAll courses require proof of identification. Some also require special permission in the form of a Visa or Resident Alien Card, a stamped I-20 and other documents. All applicants will need to sign a hard copy the student application prior to flight training.Next step: I would prefer*Select one...to receive a phone call.to receive an email.to schedule an appointment.some other form of contact.If you selected "some other form of contact."*CommentsThis field is for validation purposes and should be left unchanged.