| Mail or Fax To: Carolina South Aeronautical Testing and Certification Center 2740 Madison Highway Valdosta, GA. 31601 FAX 229-244-9559 If you have questions ro need to contact us, please call or E-Mail at: Office 229-269-4602 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 Carolina South Aeronautical.
V.A. reimbursement for F.A.A. - A
and P = $ 1,200.00 and $ 800.00,
(O&P & I.A Courses Require The AC 43 & FAR Materials) NOTE - All Rates Subject to Change Without Notice! 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 _______________________________________ |