BALLOON EXCELSIOR SCHOOL

FAA-Approved Balloon Flight School, Air Agency IA8S209Q
P.O. Box 4055
711 Industrial Park Drive
Manteca, Ca 95337

Phone 209-825-4290 Fax 209-825-5372
Email: info@balloonexcelsior.com


FLIGHT SCHOOL APPLICATION
(print out this form, then fill out and mail)

Name _____________________________________________ Date __________________

Address___________________________________________________________________

__________________________________________________________________________

Phone ________________ Fax ____________________ E-mail: ____________________

Age _____ Sex _____ Health ___________

Preferred dates for training: ________________________________________________

Flight certificates held (if any): _____________________________________________

______________________________________________________________________

Previous documented balloon flight instruction (if any): Total Hours: __________

Instructor(s): ___________________________________________________________

PERSON TO CONTACT IN CASE OF EMERGENCY

Name _____________________________________________

Address___________________________________________________________________

__________________________________________________________________________

Phone ________________ E-mail: ____________________

Minimum deposit to reserve dates: $1,000.00. Balance due at commencement of training.

Amount enclosed: $___________



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