| Mail or Fax To: Aviation School of Excellence Testing and Certification Center 2740 Madison Highway Valdosta, GA. 31601 FAX 229-244-9559 If you have questions or need to contact us, please call or E-Mail at: Office 229-269-4482 Toll free 1-866-369-8068 info@aircraftcrewchief.com Please return this Registration Form with your required personal information and remittance. Checks must be received a minimum of three weeks prior to attending The Aviation School of Excellence. Date: ______________________ NAME (first)________________________ (middle) _____________________ (last) _____________________ Social Security # ____________ - ______________ - _________________ Address _______________________________________________________ City_________________________________ State / Province______________________ County_________________________________________ Home Phone # ____________ - ___________ - _________________ Wk Phone #____________ - ___________ - _________________ Cell Phone # ____________ - ___________ - _________________ Birth Date _________ / _________ / _____________ (MM) (DD) (YYYY) Citizen of _______________________ Male _________ or Female __________ Requested Training Dates: Month ____________ Date ________ Year ____________ (Note* A & P certification process = approx. 10 to 14 days) Course(s) Requesting: Course 1 _______________________________________ Course 2 _______________________________________ Course 3 _______________________________________ Course 4 _______________________________________ |