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Sierra Academy of Aeronautics Application
 
General Information :
 
Last Name :
First Name :
Middle Initial :
Date of Birth :
Sex :
Citizenship :
Social Security Number :
Email :
Present Address :
Street :
City :
State :
Zip :
Permanent Address :  
Street :
City :
State :
Zip :
Day time Phone :
Evening Phone :
 
Physical Condition :
 
Height :
Weight :
Hearing Difficulty :
 
Explain if yes :
Vision : /20
  If less than 20/20 corrected to: /20
What is your general physical condition
FAA Medial Certificate held, if any
Class
Date issued:
 
Education Background :
 
High School
City
State
Dates attended
From
To
Graduated
Yes No
If No : GED : Yes No
Date
College / University
City
State
Dates attended
To
From
Major
Graduated
 
Military Background :
 
Branch
Rank
Months of active duty
Last day of duty
Eligible for the GI Bill Yes No
 
Aviation Employment Background :
 
Please list employers, positions, duties and periods of employment
 
Aviation Experience : (None Required)
 
Certifications/Ratings held
FAA written exams passed
Aviation schools attended
Locations
Programs
Approvals
Date
Total flight hours
FAA approved school flight hours
Dual
Solo
 
Courses Desired : (check all that apply)
 
Commercial pilot – includes instrument rating and multi-engine certification
Flight Instructor (CFI and CFII)
Flight Instructor - Multi-Engine
Airline Transport Pilot (ATP)
Complete Professional pilot program (all of the above components) with the Direct Track Internship
Aircraft Dispatcher
 
College Degree Option : (check all that apply)
 
A corresponding application from Embry-Riddle Aeronautical University will be provided if you indicate an interest in this option
Associates Degree – Professional Aeronautics
Bachelor of Science – Professional Aeronautics
Master of Science – Business Administration in Aviation
 
Class Dates Requested : (classes start on the first Monday of every month)
 
1st choice month :
2nd choice month :
 
Housing Referral Request :
 
Please be advised of my interest in housing in this area.
Please send me current information you may have of housing near your training facility.
 
Special Requests :
 
Please let us know of any special requests that you may have :
 
Referrals :
 
Please let us know if you have any friends that may be interested in a career in aviation.
Referral 1  

Name
Street address

City

State

Zip
Phone

Email

Program
Referral 2

Name
Street address

City

State

Zip
Phone

Email

Program
 
How Did You Hear About Sierra Academy :
 

Referral – please provide the name of the organization / individual :
Magazine Advertisement – Magazine Name :
Internet search engine :

Other :
 

 
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