PAN AM STUDENT APPLICATION 5000 NW 36th Street, Miami, FL 33122 www.PanAmAcademy.com PAN AM INTERNATIONAL FLIGHT ACADEMY 305-874 6000 5000 NW 36TH STREET Email Application to: [email protected]MIAMI, FL 33122 Telephone (305) 874-6000 Fax: (305) 874-6612 Name of Applicant (Please print): Must be written as it appears on your passport Last:_____________________________First:_______________________________Middle:_______________________________ Present Address: Street & Number_________________________________________________City_______________________________________ State / Province __________________________ Country: ________________ Postal code______________________________ Telephone (include country code)____________________________ EMAIL:_________________________________________ Emergency Contact (Please print): Last:_____________________________First:_______________________________Middle:_______________________________ Emergency Contact Address: Street & Number_________________________________________________City_______________________________________ State / Province __________________________ Country: ________________ Postal code______________________________ Emergency Telephone (include country code)_________________________________________________________________ EMAIL ADDRESS:__________________________________________________________________________________________ Personal Information: Gender:______ Male:______ Female Height:______ Cm / Inch Weight:______ (Kilos /Lbs) Eyes:_____________________ Hair: ________________________ Place of Birth______________________________ Date of Birth:______/ _____/ ________ MONTH DAY YEAR Marital Status: ________ Single ________ Married Current Occupation: __________________________________________ Passport Number:_____________________________ Country of Citizenship:______________________________________ Drivers License (If applicable) __________________________________ Country: ____________________________________ Drug / Alcohol Conviction within the past 12 months: ________Yes _________No
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PAN AM STUDENT APPLICATION STUDEN… · PAN AM STUDENT APPLICATION 5000 NW 36th Street, Miami, FL 33122 PAN AM INTERNATIONAL FLIGHT ACADEMY 305-874 6000 5000 NW 36TH STREET Email
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5000 NW 36TH STREET Email Application to: [email protected] MIAMI, FL 33122 Telephone (305) 874-6000 Fax: (305) 874-6612
Name of Applicant (Please print): Must be written as it appears on your passport Last:_____________________________First:_______________________________Middle:_______________________________
Present Address:
Street & Number_________________________________________________City_______________________________________
State / Province __________________________ Country: ________________ Postal code______________________________
Telephone (include country code)____________________________ EMAIL:_________________________________________
No previous experience required. This course combines the private, commercial, instrument and multiengine courses marked with an asterisk (*)
_____ AIRCRAFT DISPATCHER TRAINING _____ AB INITIO (200 HOURS)
_____ ADVANCED (80 HOURS)
_____ AIR TRAFFIC CONTROLLER _____ AB INITIO ______ RECURRENT
APPLICATION AGREEMENT
1. Please fill out this form entirely.2. Attach a clear photocopy of a valid Passport, (if applicable attach license and visa)3. Attach a bank statement demonstrating that you or your sponsors have the financial resources required for your education in the US. (funds shown should reflect flight course tuition)4. Upon receipt of the above via e-mail, an I-20 form and acceptance letter will be sent to you (applicant). You will then be able to proceed to a US Consulate or Embassy in your country to request an M-1 visa.5. Upon arrival to Pan Am International Flight Academy, students are enrolled according to the requirements of the training center, the course purchased and US Government regulations.6. Before arrival, a deposit equal to 50% of the estimated tuition cost is required prior to starting the Program. The remaining balance of 50% must be paid at arrival to Pan Am International Flight Academy. (A minimum $2,500 deposit must be made prior to Scheduling a class)7. Student accepts that they have clearly read their sales agreement and fully understand all elements of the training they are purchasing.
Signature Approval of Applicant:
I apply for admission to the course(s) indicated, and accept the above terms and conditions.
Student Signature:______________________________________________________________ Date: ______ / ______ / ______ MON DAY YEAR
Parent / Guardian Sponsors
Where the students are under the authority of parents, guardians, etc., the responsible authority must sign here: I accept the above terms and conditions: