Course Registration – Elite Rigging Academy

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Course Registration

Please enter student information bellow.

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Student Name *

First

Middle

Last

Extra Info

Cell Phone

Height

Hair Color

Sex

Date of Birth *

Email *

Weight

Eye Color

Citizenship / Nationality

Place of Birth

Do you now or have you ever held an FAA Airman Certificate? *

Please specify your Certificate Type and or Number:

Have you ever had an FAA Airman certificate suspended or revoked? *

Have you ever been convicted for violation of any federal or state statutes pertaining to narcotic drugs, marijuana, and depressant or stimulant drugs or substances? *

Please specify date of final conviction:

Do you read, write, speak and understand the English language? *

T-Shirt Size *

Small
Medium
Large
Extra Large XL

How did you hear about us?

Select Course *

Choose a Course Date* *

Physical Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Payment Method *

Credit Card - $ 4,155.00
Mail in Check - $ 4,000.00

Mail in Instruction

Please send your $4000 cheque; it should be addressed to Elite Rigging Academy Inc. Our address is the following:

Elite Rigging Academy
4439 Sky Dive Ln.
Zephyrhills, FL, 33542

Payment Information *

Card

Name on Card

Total

$ 0.00

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