Aviation Registration

W.I.N.G.S

If youth is under the age of 18, the youth must have a signed parent's permission form on file with Employee Connections prior to starting the class.

Click here to download, print out, and have parent to sign the parent permission form.

To qualify for special payment arrangements, please contact our office at 847-360-7177

Course Material Fee: $50.00 • You may send your fee by selecting Zelle or PayPal.

This includes in person instructor by a licensed pilot, curriculum, literature, your first flight bag and wings plus resources for future use.

First Name *

Last Name *

Address

Apartment

City

State

Zip / Postal Code

Home Telephone Number

Cellular Telephone Number

E-mail Address *

Age

Gender

Ethnicity / Race

Do you have any medical concerns that we should be made aware of?

First Name

Last Name

Telephone Number

E-mail Address

Proof of Residency

Proof of Age

Photo ID

Emergency Contact Information

What grade level and school you are currently in?

Have you ever been on an airplane?

Why do you want to learn how to fly an airplane?

Are you interested in learning about careers in aviation?

How did you learn about our program?

Please choose method of payment

If paying by check, make it payable to Employee Connections and mail to:

• Employee Connections, 2504 Washington Street, Suite 100, Waukegan, Illinois 60085.

• Checks must be received at least one week prior to class begins.

To qualify for special payment arrangements , please contact our office at 847-360-7177

* Official Office Use Only *

Signature

Date

Signature

Date

Aviation Registration Form

*** Official Office Use Only ***

* Official Office Use Only *