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Name

Father's Name
Occupation
Date of Birth
Place of Birth
Passport Number Issued at
    Issued Place
Expiry Date
Nationality
Age
Height
Weight
Sex Male Female
List of Enclosures 10th Marksheet Yes No
  12th Marksheet Yes No
  Age Proof Yes No
  Medical Certificate Yes No
  Character Certificate Yes No
  Educational Qualifications Yes No
  Local Police Verification Yes No
       
Past Experiance Day Solo Day Dual  
  Night Solo Night Dual  
       
License / No. / Validity Aircraft Endorsed:
       
Address
 
City State
State Phone
Pincode Email
Caste Religion
       
Srno. Exam Board/University Subject Marks Obtained %
1 10th
2 10 + 2
3 10+2+3
 
Course Applied for
Ground Training

Student Pilot License
Private Pilot License
Commercial Pilot License
Hobby Flying
Flexi Flyers Program
 
India PPL No. Total Hours
PIC    
       
Hours Flown: Solo
Total    
       
Parents Details      
Fathers Name Office Phone
Mothers Name Home Phone
Occupation Mobile
Office Address    
       
Application form      
Demand Draft No.
Date:
for Rs.    
Name of Bank & Branch:  
       
I request you kindly enrol me in your institute for