Online Application Form for Aviation Diploma Program

IMPORTANT: Most entry blanks or fields on this form are compulsory, and you will get an error message if you do not fill them out.
To minimize error messages, please read instructions carefully. For your convenience, compulsory fields are marked with double asterisks (**). Some fields are not compulsory, but we recommend that you fill out all fields as fully as possible.  We can not guarantee that your application will be fully processed if you do not supply adequate information. All information that you enter below is held confidential by our office.
Press TAB to move from one entry field to another. Do NOT press the ENTER key until you are done all entries.
NOTE: Pressing the ENTER key will cause the form to be processed, or checked for errors and ommisions, even if you have not finished filling it out.

A-1. Personal Information

Student Number

CanadianSocial Insurance Number (SIN)

First Name**

Middle Name

Last Name**

Former Name

Title Mr. Mrs. Miss Ms.

Marital Status Single Married Other

Gender Male Female

Birth Date **
Enter dates as month/day/year ie:  7/27/1977
You must use four digit years ie: 1977

Street/Box#**

City**

Prov/State**

Country**

Postal/Zip Code**

Home Phone**
Enter phone number as:
999-999-9999 OR  (999) 999-9999 OR
999.999.9999 OR 999 999 9999

BusPhone
Enter phone numbers as:
999-999-9999 OR  (999) 999-9999 OR
999.999.9999 OR 999 999 9999

Email Address:

A-2.  In case of emergency, contact:

Name of Emergency Contact: **

Their Relationship to you** Choose option Parent Spouse Offspring Relative Friend Neighbour Employer

Their phone number is: **
color="#0000a0">Enter phone numbers as:
999-999-9999 OR  (999) 999-9999 OR
999.999.9999 OR 999 999 9999

A-3. Citizenship Status

Choose one of the following options which best describes your citizenship status as a student in Canada: ** Choose option Canadian Citizen Permanent Resident Landed Immigrant Student Visa Other Visa If you choose "Canadian Citizen" in the above question, then use your tab
   key to skip to Section B, labelled "Academic Records"

If you did not choose "Canadian Citizen" above, please complete the following four questions: **

1. Indicate the date of your entry into Canada:

2. Country of current Citizenship:

3.Country of residence during the previous year

4. What is your mother tongue or native language?

Address of High School attended last:**

Dates of last attendance:

From:

Year: **   Month: **

To:

Year: **   Month: **

Grade Level or Diploma achieved: **

B-2. Post Secondary Academic Record

Have you ever attended a post secondary institution?** Choose option Yes No

If you answered "No" to the above question, use your tab key to skip to Section C labelled "Activity During the Past Year"

If you answered "Yes" to the above question, please fill out the following: **

B-2 a. Post Secondary Institution:

Name & city address:

Date of last attendance: Year: Month:

Length of Program or Course taken:

Certificate, Diploma or Degree obtained, or number of years completed:

If you attended more than one Post Secondary Institution, please fill out the
   following section, otherwise use your tab key to skip to Section C labelled
   "Activity During the Past Year"

B-2 b. Post Secondary Institution:

Name and address

Date of last attendance: Year:   Month:

Length of Program or Course taken:

Certificate, Diploma or Degree obtained, or number of years completed:

If you attended more than two Post Secondary Institutions, please fill out the following section, otherwise use your tab key to skip to Section C labelled "Activity During the Past Year"

B-2 c. Post Secondary Institution:

Name and address

Date of last attendance: Year:   Month:

Length of Program or Course taken:

Certificate, Diploma or Degree obtained, or number of years completed:

C. Activity During the Past Year

Activity: ** Choose option Student Employed Job Hunting Other

Location of this activity ** Choose option Alberta Other Province Outside Canada

D.  Details of Application for Red Deer College

Have you ever been required to withdraw from an educational institution? ** Choose option Yes No       If yes, what year?

Have you previously applied to Red Deer College? ** Choose option Yes No       If yes, what year?

If yes, what program did you apply for?

Have you previously completed a credit course at Red Deer College?

**  Choose option Yes No If yes, what month? what year?

E.  Program Details

Term applying for: ** Choose option Fall Spring

Do you currently have a Private Pilot License (PPL)?  Choose option Yes No

If yes, then enter Private Pilot Licence Number:

Total flying hours:

Total dual flying hours since obtaining Private Pilot License: 

Rating and endorsements held: 

Date of last medical examination:

Medical examination category:

F.  Payment Details

There is a $50.00 non-refundable deposit.
Please call Skywings with your credit card or other payment information to compliment this application form.