Perimeter Aviation Student Registration Information
 
HOME INFO.
First Name Last Name
Address
Email
City Prov.
Postal Code Home Phone
Hotel Room#
Canadian Student Credit Card
Credit Card# Expiry
 
EMPLOYMENT INFO.
Employer
Occupation
Business phone#
 
LICENSE INFO.
License# Medical Category
Check one of following:  
Last Medical Date: Accident History
 
NEXT OF KIN
First Name Last Name
Relationship Home Phone
Address City
Prov. Postal Code
Address#2
Business Phone  
 
ENROLLMENT INFO.
Requested Start Date

*This form will be sent to Flight School coordinator who will contact you.

 

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