Buffalo School of Aviation

    
   
   
   
                   
                   
Applicants, please read this form carefully:
1) Complete this form in full. Print clearly. Incomplete forms will be returned to the student.    
2) Applicants with high school credits or post-secondary education must submit transcripts    
    with this application form.              
3) Notice of acceptance will be by mail. Please ensure all personal information on the form is     
    current and correct.                
4) Mail this complete form to the Buffalo School of Aviation.          
                   
Note: Fees, program schedules and delivery locations may change without notice. It is the     
responsibility of the applicant to ensure the program is available.         
                   
Personal Data                  
                   
Name:                    
  (Last Name)   (First Name)     (Middle Name)    
                   
Social Insurance No.:            
                   
Permanent Mailing address:              
        (Street/ Box Number)        
                   
                   
      (community and Prov./Ter) (Postal Code)    
                   
Birth Date:           /         /   Sex: Male         
  (year/ month/ day)     Female    
                   
Phone:           
  (residence)   (work)    
                   
Have you any medical condition(s) of which the school should be aware of ?    Yes    No    
If yes, please specify:              
                     
                   
                   
                   
Family Contact in Case of Emergency              
                   
Name:   Relationship to you:        
         
Mailing address:                
        (Street/ Box Number)        
                   
                   
      (community and Prov./Ter)     (Postal Code)      
                   
Phone:                   
    (residence)       (work)      
                   
                   
                   
Employment                  
                   
Name of Current Employer:            
         
Address:                  
        (Street/ Box Number)        
                   
                   
      (community and Prov./Ter)     (Postal Code)      
                   
Phone:                   
    (residence)       (work)      
                   
Description of Work:                 
                   
                   
                   
Education                  
                   
Highest Grade Successfully Completed (1 to 12):          
Date Completed:                
                   
Name of School Last Attended:              
                   
Address:                  
        (Street/ Box Number)        
                   
                   
      (community and Prov./Ter)     (Postal Code)      
                   
GED Grade (if Applicable):       Date Obtained:        
                   
                   
                   
Education (continued)   (please fill in where applicable)        
                     
  College :                  
  Name of Certificate/Diploma:              
  Years Attended:                
                     
  Address of College:                
                     
                     
  University: :                  
  Name of Degree/Diploma:              
  Years Attended:                
                     
  Address of University:                
                     
                     
  Journeymen Certificate :                  
  Name of Certificate:                
  Years Attended:                
                     
  Address of Institution:                
                   
                   
                   
Signature                  
                   
I certify that the above information is correct and complete. If admitted, I agree to    
comply with all rules, regulations and policies of the Buffalo School of Aviation.    
I have made arrangements to have proof of education (transcripts) forwarded to the     
the Buffalo School of Aviation.              
                   
                   
(Signature of Applicant)   (Date - year/month/day)