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Application Type: Basic Flight Instructor (BFI/mem) $140.00 per 1 year

Advanced Flight Instructor (AFI/mem) $140.00 per 1 year

Applicant’s Name (first, m.i., last):______________________________________________________________________

Address:______________________________________________________________________________________________

City:_____________________________________________State:________________Zip:_________________________

Phone (H):___________________(W): ___________________E-mail:_______________________________________

ASC Membership #B___________________ Date of Birth:____________________ Male/Female______

Background Summary

Total Time Ultralight: _________ (35 hours min for ppg), Dual UL received ____ (10 hrs minimum for ppg of total)

Other information: Total Time N-numbered Aircraft: __________

What FAA certificates do you hold, if any? _______________________________ FAA CFI #:_________________

UL types rated/active in**: Fixed wing o para wing o weight shift o sea plane o rotor wing o ppg o other

Typically fly from: airport o flight park o farm field o other o _________________________

Typically store ultralight: hangar o garage o barn o trailer o tiedown o other ______

 

__________________________________________________________________________________________

To be completed by REFERRING BFI

Certification of Instruction and Referral by Basic Flight Instructor:

I have given, or reviewed, the above applicants flight instruction experience and training appropriate for Basic Flight Instructor. I hereby recommend the applicant for Basic Flight Instructor.

Instructor’s Name (print) ____________________________Membership #B__ __ __ __ __ __

Instructor’s Signature: ______________________________Date:___________

____________________________________________________________________________________

To be completed by TESTING Advanced flight Instructor (AFI)

Written test score: ____ FOI score: ____ Oral test passed: ____ Flight test passed: _____

Ultralight "type" make and model used in flight test**_____________________________________

I have examined the applicant and reviewed their documentation of flight hours and recommend that the

applicant be recognized for authority to conduct operations under an FAA two-place ultralight training exemption.

Instructor’s Name (print) _____________________________ Membership #B__ __ __ __ __ __

Instructor’s Signature ______________________________ Date____________:

Send forms and check to:

Aero Sports Connection
231 SW Bonanza Glen
Lake City, Fl 32025

Phone 269-209-1466