Australian Aviation Training Agency Offline Enrolment Form
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Required Fields
SECTION 1 : COURSE ENROLMENT DETAILS
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Institute
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- Select Institute -
Australian Wings Academy
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Course
- Select Course -
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Date which you wish to Commence
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SECTION 2 : STUDENT'S DETAILS
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Title
Mr
Mrs
Miss
Ms
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Given Name(s)
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Preferred Name
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Family Name/Surname
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Date of Birth
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1911
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1907
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1904
1903
1902
1901
1900
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Sex
Male
Female
Email
SECTION 3 : CITIZENSHIP / PASSPORT DETAILS
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Country of Citizenship
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Country of Birth
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Passport Number
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Passport Expiry Date
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YYYY
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2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
SECTION 4 : STUDENT'S CONTACT DETAILS IN HOME COUNTRY
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Street
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Suburb / Province
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Country
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Zip / Postcode
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Telehone Number
SECTION 5 : PARENT / GUARDIAN DETAILS
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Title
Mr
Mrs
Miss
Ms
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Given Name(s)
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Family Name / Surname
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Telehone Number
SECTION 6 : STUDENT DISABILITIES
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Do you consider yourself to have any permanent and significant disabilities?
No
Yes
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If 'Yes', select all relevant disabilities.
Visual/sight/seeing
Hearing
Physical disability
Intellectual disability
Chronic illness
Other (please specify)
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Do you require special assistance because of the disability?
No
Yes
SECTION 7 : PREVIOUS FLYING EXPERIENCE
Hours Flown
Dual
Solo
Total Flying Hours
Licences Held (please tick)
Private Pilot's Licence
Commercial Pilot Licence
Air Transport Licence
Ratings Held (please tick)
Night VFR
Flight Instructor
Command Instrument
Flying School / Club Name
Flying School / Club Country
Experience / Other
SECTION 8 : ENGLISH LANGUAGE PROFECIENCY
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Is English your native language?
No
Yes
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If “No” please indicate your level of English education (if any) and any relevant test scores eg. IELTS, TOEFL, other
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Do you wish to undertake further English training in Australia?
Yes
No
If you answer “Yes” we will send you information regarding English courses.
SECTION 9 : CONTACT DETAILS IN AUSTRALIA (if known)
Street
Suburb
Country
Australia
Postcode
Telephone Number
SECTION 10 : TRANSPORT IN AUSTRALIA
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How do you plan to get to your Institute?
Walk
Train
Tram
Bus
Car
Motor Cycle
Bicycle
Don't know
SECTION 11 : TERMS AND CONDITIONS
- Terms and Conditions
I have read and agree to the terms and conditions stated above. (Please tick)
PRINT/FAX FORM
Print out and fax this form to +61 3 9858 2274.