Train-A-Pilot Form | EAA Chapter 274 | Experimental Aircraft Association

First Name*
Middle Name
Last Name*
Preffered Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Email*
Date of Birth*
MM slash DD slash YYYY
Birthplace*
Citizenship*
Brothers or sisters (list name and age)

School & Activities
Please tell us about your education and extracurricular activities.
School Attending*
Grade Level*
Other Schools
Subjects and GPA
Extracurricular Activities
Hobbies
Employment and/or Volunteer Record
Company or Employer Name
Position
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
End Date to Present
- to Present
Add Another Employment
- Add Another
Company or Employer Name
Position
Start Date
MM slash DD slash YYYY
End Date
MM slash DD slash YYYY
End Date to Present
- to Present
Please describe any flying experiences you have had in any type of aircraft.

Please include a statement of 500 words or less on the following topic: “Why I Would Like to Become a Pilot”*
Agreement*
I consent to having Decatur EAA store my submitted information so they can review my application and contact me by email or phone.

Father's Information