Aviation Institute of Maintenance

Application For Admission
PLEASE FILL OUT COMPLETELY

WHICH CAMPUS WOULD YOU LIKE TO ATTEND?
FIRST NAME
MIDDLE
LAST NAME
AGE
DATE OF BIRTH
ADDRESS (STREET)
CITY
STATE
ZIP CODE
HOUSING
HOME PHONE
WORK PHONE
MARITAL STATUS
DRIVER'S LICENSE
OWN CAR
EMAIL ADDRESS
EMAIL ADDRESS 2
CELL PHONE
ETHNICITY (Survey for US Department of Education)
GENDER
CITIZENSHIP

SPOUSE'S NAME
SPOUSE'S OCCUPATION
COMPANY
PHONE

NEAREST RELATIVE'S NAME
NEAREST RELATIVE'S OCCUPATION
COMPANY
PHONE

HAVE ANY OF YOUR FRIENDS OR RELATIVES ATTENDED THIS SCHOOL?
NAME OF FRIEND OR RELATIVE WHO ATTENDED THIS SCHOOL?
HOW DID YOU LEARN ABOUT US?
TRANSPORTATION
AVAILABILITY DATE
INTENDED PROGRAM OF STUDY
HOBBIES & INTERESTS
Military Service
YOU MUST ANSWER EACH OF THE FOLLOWING QUESTIONS COMPLETELY.

ARE YOU A VETERAN?
REGISTERED FOR SELECTIVE SERVICES (males only)
IS YOUR SPOUSE OR PARENT ON ACTIVE MILITARY DUTY OR A VETERAN? (You might be eligible for free tuition!)
Level of Education

HIGH SCHOOL

NAME OF SCHOOL
CITY
STATE
FROM (Month, Year)
TO (Month, Year)
YRS COMPLETED
GRADE AVG.
DEGREES TITLE
GRADUATED
MAJOR OR SUBJECTS
COLLEGE / UNIVERSITY / OTHER

NAME OF SCHOOL
CITY
STATE
FROM (Month, Year)
TO (Month, Year)
YRS COMPLETED
GRADE AVG.
DEGREES TITLE
GRADUATED
MAJOR OR SUBJECTS
Employment
START WITH PRESENT OR MOST RECENT POSITION HELD INCLUDING MILITARY EXPERIENCE.

FROM (Month, Year)
COMPANY NAME
ADDRESS
CITY
STATE
ZIP CODE
TO (Month, Year)
POSITION, TITLE OR RATING
INDUSTRY OR PRODUCTS
SUPERVISOR NAME
SUPERVISOR TITLE
SUPERVISOR PHONE
DUTIES

FROM (Month, Year)
COMPANY NAME
ADDRESS
CITY
STATE
ZIP CODE
TO (Month, Year)
POSITION, TITLE OR RATING
INDUSTRY OR PRODUCTS
SUPERVISOR NAME
SUPERVISOR TITLE
SUPERVISOR PHONE
DUTIES

FROM (Month, Year)
COMPANY NAME
ADDRESS
CITY
STATE
ZIP CODE
TO (Month, Year)
POSITION, TITLE OR RATING
INDUSTRY OR PRODUCTS
SUPERVISOR NAME
SUPERVISOR TITLE
SUPERVISOR PHONE
DUTIES
References

REFERENCE
OCCUPATION
COMPANY
ADDRESS
PHONE

REFERENCE
OCCUPATION
COMPANY
ADDRESS
PHONE

REFERENCE
OCCUPATION
COMPANY
ADDRESS
PHONE

All of the above information is accurate and correct to the best of my knowledge. I hereby authorize the school or its agent to communicate with any person, credit reporting agency, firm or corporations, including my employer, in respect to my suitability to attend school. Further, by submitting this application, I give consent to Aviation Institute of Maintenance, and their agents, to contact me by email or telephone (both mobile and home, including pre-recorded and/or using auto-dialers) at the number I have provided in the form above to receive marketing information about Aviation Institute of Maintenance's programs, offers and general information about our school as part of our Privacy Policy.. I understand that my consent to receive SMS text messages is not required to get a quote or to purchase any products or services from Aviation Institute of Maintenance, or its affiliated schools or companies, and that I may instead reach Aviation Institute of Maintenance or its related entities by phone at 1-888-349-5387 to proceed without giving this consent. I agree to submit any claims arising out of my attendance or any aspect thereof, including disputes concerning alleged civil rights violations, to binding arbitration.
APPLICANT SIGNATURE:
DATE: