|YOUTH IN AVIATION (YIA)
DATE OF BIRTH ________________
GRADE LEVEL FALL 2007__________ SCHOOL _______________________________________
Have you attended an Aviation camp before? _________ When & Where:___________________________
STUDENT: I will attend the full program. I have read and agree with the Youth in Aviation guidelines.
Student Signature _______________________________Date________
PARENT/GUARDIAN NAME ___________________________________
HOME PHONE ____________________WORK PHONE _________________
As the parent/guardian, I certify that my child has permission to participate in the Youth in Aviation camp. My child
will attend the full program and can be removed for inappropriate conduct.
PARENT/GUARDIAN SIGNATURE ________________________________ DATE ________________
COMPLETION OF THIS SECTION IS VOLUNTARY AND USED TO DETERMINE HOW WELL THE PROGRAM
SERVES ALL SEGMENTS OF THE POPULATION.
AFRICAN AMERICAN_______NATIVE AMERICAN_______HISPANIC________
LOGISTICS: Applicants will be notified of selection by July 11, 2007. Students/parents are responsible for
transportation to and from the program. Transportation for field trips is provided. Food and snacks are included.
STUDENT PROFILE: NAME______________________________________________
[YOU MAY ATTACH ADDITIONAL INFO, SUCH AS REFERENCES, RESUME, ETC.]
- RELATE ANY SPECIAL INTERESTS THAT YOU HAVE RELATING TO AVIATION.
- LIST SCHOOL AND COMMUNITY ACTIVITIES OF THE PAST 2 YEARS.
- DESCRIBE JOBS OR DUTIES AT HOME OR SCHOOL THAT DEMONSTRATE YOUR COMMITMENT TO A
- WHAT ARE YOUR CAREER GOALS?
- WHY DO YOU WANT TO ATTEND YOUTH IN AVIATION CAMP?
This form must be printed, mailed, signed by the parent/guardian and submitted by Feb 15, 2008.
ELIGIBILITY: Participants must be students between the ages of 12-18. Include the $25.00 fee with