Student's

Online Registration Form

Student Information

Total Pilot Time:

Certificate:

Ratings:

Airline fly for:

Time in past 12months in light aircraft:

Your Weight: Pounds

Your Weight: Height

If you are over 260 pounds as you fly (w/clothes, shoes, etc.), call Vern…

Why do you want your Single Engine Sea rating?

Course Chosen:

NOTE: All study materials may be download from our website. www.alaskafloatratings.com

*Dates when you would like your lessons scheduled:

We suggest you add an extra calendar day in case of wx delays.

A $500 non-refundable deposit is required to place you on the schedule.

Check Enclosed?

No

PLEASE! Send us a check made out to: Alaska Float Ratings. Mail to: P.O. Box 4 Moose Pass, AK 99631.

NOTE: You may use your , Visa or MasterCard, BUT, We have been forced to charge 3% to defer fees

OK, Just charge $500 + 3% to my Visa / Master Card No:

Expires:

Signature:

Vern will call you for the 3 digit security code.

How did you find out about us?

Referred By:

Please indicate whether you’d like more information on the following. We can book these for you:

Lodging:

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