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Mail or Fax To:

Aviation School of Excellence Testing and Certification Center
2626 Madison Highway, Suite 202
Valdosta, GA. 31601

FAX 229-671-9002

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
aviationschoolofexcellence@surfsouth.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 _______________________________________