FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018

3940 AVIATION CIRCLE, NW

ATLANTA, GA 30336
Student Application
www.flyace.org

1. Student Information
Please take a moment to complete our application for enrollment in the Aviation Career Enrichment (ACE) Weekend Flight Academy. The ACE
Weekend Flight Aca emy provides education and training to youth ages 9 to 18 and does not discriminate based on race, national origin, religion,
gender, sexual orientation or disability status. Due to specific Federal Aviation Regulations, only US Citizens may enroll in ACE. Thank you for
your interest in joini g ACE!
I am a NEW student applicant I am a RETURNING student
Todays Date Last Name First Name Middle Name

Street Address + Unit/Apt Number City County State Zip Code

Home Phone Cell Phone E-Mail Address Parent E-Mail Address

Date of Birth Age Place of Birth Nationality Gender

Month / Day / Year County / State / Country I am a US Citizen

I am NOT a US Citizen
1 Have you ever submitted an application for the Aviation Career Enrichment (ACE) Weekend Flight Academy? Yes No
If yes, when did you apply?
2 Have you ever been enrolled in the Aviation Career Enrichment (ACE) Weekend Flight Academy? Yes No
If yes, when were you enrolled?
3 Do you have any friends or relatives currently enrolled in ACE? Yes No
If yes, list name and relationship to you.
4 Have you ever been convicted, pled guilty, pled no contest or nolo contendre to any crime? Yes No
5 Are any charg s currently pending against you? Yes No
6 Are you currently on probation, performing community service or part of a work release program? Yes No
7 Have you ever received any type of flight instruction in an airplane? Yes No
If yes, where did you rece ve instruction? How many hours do you have?
8 Do you currently hold a Private Pilot Certificate? Yes No
If yes, Date of Issue: Place of Issue/Instruction:
9 Do you currently hold an FAA Medical Certificate? Yes No
If yes, Date of Issue: Class:
2. Educational History & Goals
E G
High School City State County Currently Attending GPA
Attended from to
Will attend in
Middle School City State County Currently Attending GPA
Attended from to
Will attend in
Elementary School City State County Currently Attending GPA
Attended from to
Will attend in
Where do you wish to attend college? I have applied Desired Major
I will apply in the future
I have not applied but would like assistance completing
application

2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 1 of 7)

Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

Todays Date Student Applicant Last Name Student Applicant First Name Student Applicant Middle Initial

3. Parent/Guardian Information
m
Mother Primary First and Last Name Primary Contact Phone Primary E-Mail Address
Father
Legal Guardian
Mother Secondary First and Last Name Secondary Contact Phone Secondary E-Mail Address
Father
Legal Guardian
4. Students Letter of Interest
Please us the following area to provide a brief summary (one to two paragraphs) describing your interest in aviation or aerospace and why you are
interested in attending the Aviation Career Enrichment weekend academy. Attach a separate sheet if needed.

5. Medical
M History and Disclosure
The following medic l information may become necessary to review and/or make available in the event of an incident, accident or onset of illness.
Please complete this form accurately and truthfully. The information you provide will remain confidential and will only be provided to Aviation
Career Enrichment staff members and qualified emergency personnel in the event of a situation that requires medical attention.
Primary Care Physician (PCP) First and Last Name PCP Office Phone Practice or Group

Primary Emergency Contact First and Last Name (to contact first) Primary Home Phone Primary Cell Phone

Secondary Emergency Contact First and Last Name Secondary Home Phone Secondary Cell Phone

1 Are you currently taking any medications (prescription or non-prescription)? Yes No

If yes, specify drug name, dosage, frequency and reason for taking.

2 Do you have any physical disabilities, chronic illnesses, allergies, previous injuries or any other limitations that
could affect your full participation in this program? Yes No
If yes, please provide additional information.

3 Do you have any physical, emotional or physiological limitations that would affect your participation in flying an
airplane (fear of heights, depth perception, spatial orientation, behavior disorder, etc.)? Yes No
If yes, please provide additional information.

2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 2 of 7)

Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

Applicants Statement
*PLEASE READ CAREFULLY BEFORE SIGNING*
*MUST BE SIGNED BY STUDENT AND AT LEAST ONE PARENT/LEGAL GUARDIAN)*
We hereby certify that all of the information provided by the student applicant and parent/legal guardian in this application (or any of
our accompanying or required documents) is correct, accurate and complete to the best of my knowledge. We understand that the
falsification, misrepresentation or omission of any facts in this application or other related documents will be cause for denial of
enrollment or immediate expulsion from the Aviation Career Enrichment program regardless of the timing or circumstances of
discovery.
We understand that submission of an application does not guarantee enrollment. We further understand that, should the student applicant
be accepted that such enrollment is at will, for no specified duration and may be terminated by either Aviation Career Enrichment or the
student or parent/legal guardian at any time, with or without cause or notice. We understand that none of the documents, policies,
procedures, actions, statements of Aviation Career Enrichment or its representatives used during the enrollment process is deemed a
contract real or implied. We understand that no representative of Aviation Career Enrichment except the President or Chairman of the
Board of Directors has the authority to enter into any agreement guaranteeing any conditions of enrollment or any agreement contrary to
the foregoing statements and that any such agreements must be made in writing and signed by the President and one officer of the Board
of Directors.
In consideration for enrollment with Aviation Career Enrichment, if accepted, the student agrees to conform to the rules, regulations,
policies and procedures of Aviation Career Enrichment at all times and understand that such obedience is a condition of enrollment. We
understand that due to the nature of the Aviation Career Enrichment program, attendance and punctuality are considered essential
requirements of Aviation Career Enrichment and that poor attendance or tardiness will result in counseling and possible expulsion. We
also understand that participation in the Aviation Career Enrichment program involves activities conducted at Fulton County Airport
and at other aviation locations including field trips to other airports or aviation facilities. Additionally, we understand that participation
may involve flight training experience in an airplane with an FAA Certificated Pilot who is also a Certificated Flight Instructor.
We herby authorize any and all schools, references, courts and any others who have information about the student applicant to provide
such information to Aviation Career Enrichment and we release all parties involved from any and all liability for any and all damage
that may result from providing such information.
We provide permission for Aviation Career Enrichment to use photos that may be taken during the course of routine classroom activities
and special events and grant authorization to use such photos in booklets, promotional materials, video productions or other collateral
advertising means.
We understand that this application is considered current for 90 days after the day signed. If the student wishes to be considered for
enrollment after this period a new application is required.
BY SIGNING BELOW STUDENT APPLICANT AND PARENT/LEGAL GUARDIAN ACKNOWLEDGE, UNDERSTAND AND
AGREE TO THE ABOVE STATEMENTS.
STUDENT APPLICANT SIGNATURE PRINTED FIRST AND LAST NAME DATE

PARENT/LEGAL GUARDIAN SIGNATURE PRINTED FIRST AND LAST NAME DATE

Using this checklist, submit the following items with your completed application:
Student Application (signed by both parent and student applicant)
Letter of Interest (included in Section 4 of application/attach second sheet if needed)
Code of conduct (signed by both parent and student applicant)
Copy of v lid (non-expired) government issued identification
Passport, OR
State Identification Card AND Birth Certificate
Registration Fee _____ $100 (new student) _____ $75 (returning student)
First Months Tuition $100
2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 3 of 7)
Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

Code of Conduct
The goal of Aviation Career Enrichment, Inc. (ACE) is to introduce young men and women to careers in aviation.
However, before participating, we must emphasize some important rules necessary to provide a safe and enjoyable
experience. ACE will provide hands on opportunities in many areas. For example, you will be allowed to pilot an
actual aircraft or full-motion simulators and participate in field trips. These activities are not inherently dangerous
and can be a lot of fun. However, if an individual is unable to follow the rules, these activities can be extremely
hazardous. For this reason, the Staff will observe your compliance with every rule, no matter how insignificant it
may appear to you. A person who cannot follow the simplest rule, cannot be expected to follow those more
complex. Therefore, you must comply with each and every rule at all times. YOUR FAILURE TO DO SO
WILL SUBJECT YOU TO EXPLUSION. Parents, please take this opportunity to review these rules with your
son and/or daughter:

Plan to attend each session and arrive on time.

Respect staff members, adults and each other at all times.
The uniform will be a neat pair of Khaki pants/shorts/skirt, the issued t-shirt or polo/golf shirt, belt, shoes and cap.
The uniform must be worn neatly and properly at all times.
Music devices, cell phones, games or similar items are not to be used during instruction time.
Do not bring valuables with you. There is no place to store them.
During presentations, refrain from talking and disrupting class; pay attention.
No horse playing, bullying, fighting, cursing or disrespectful language at any time.
Address all adults as Mr., Ms., Maam, Sir, or by their official title, unless you are authorized to do otherwise.
No chewing gum or tobacco products in classrooms, buses or while on scheduled tours/field trips.
No smoking at any time.
Do not leave any trash or debris in any work area.
If you feel sleepy during the presentations, quietly stand up for a few minutes to get mentally refocused and then
quietly sit back down.
When on field trips, do not stray off by yourself. Stay with the group. If you must use the restroom, let a
chaperone staff member know before doing so. Do not leave trash on the bus. Be courteous to the driver at all
times. Follow his/her instructions.
While at the weekly sessions, or on field trips, please remember that you are a member of ACE. You are
responsible for your personal conduct. Your personal conduct reflects upon the entire group. If you make
yourself look bad, you make our entire group look bad.
Violation of this rule could result in immediate expulsion.
If you have any special problems or concerns, contact a staff member immediately.

You may be given additional instructions as your training progresses. Please obey those in authority and respect them at
all times.

BY SIGNING BELOW STUDENT APPLICANT AND PARENT/LEGAL GUARDIAN ACKNOWLEDGE, UNDERSTAND

AND AGREE TO THE ABOVE RULES.

STUDENT APPLICANT SIGNATURE PRINTED FIRST AND LAST NAME DATE

PARENT/LEGAL GUARDIAN SIGNATURE PRINTED FIRST AND LAST NAME DATE

2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 4 of 7)

Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

Aviation Career Enrichment, Inc. (ACE)s Computer Policy

Aviation Career Enrichment, Inc., recognizes that use of the Internet and e-mail has many benefits and can make our
learning environment more efficient and effective. Therefore, students are encouraged to use the Internet and e-mail
systems appropriately. Unacceptable use of the Internet and e-mail can place Aviation Career Enrichment, Inc., and
others at risk. This policy outlines the companys guidelines for acceptable use of the Internet and e-mail.

Scope

This policy must be followed in conjunction with other Aviation Career Enrichment, Inc., policies governing
appropriate workplace conduct and behavior. Aviation Career Enrichment, Inc., complies with all applicable federal,
state and local laws as they concern the student/students relationship, and nothing contained herein should be
construed to violate any of the rights or responsibilities contained in such laws.

User Guidelines

Aviation Career Enrichment, Inc., has established the following guidelines for student use of the companys
technology and communications networks, including the Internet and e-mail, in an appropriate, ethical and
professional manner.

1. All technology provided by Aviation Career Enrichment, Inc. (ACE), including computer systems,
communications networks, company-related work records and other information stored electronically, is the
property of the company and not the student. In general, use of the companys technology systems and
electronic communications should be job-related and not for personal convenience.
2. Students may not use Aviation Career Enrichment, Inc. (ACE)s Internet, e-mail or other electronic
communications to transmit, retrieve or store any communications or other content of a defamatory,
discriminatory, harassing or pornographic nature. No messages with derogatory or inflammatory remarks
about an individuals race, age, disability, religion, national origin, physical attributes or sexual preference may
be transmitted. Harassment of any kind is prohibited.
3. Disparaging, abusive, profane or offensive language; materials that might adversely or negatively reflect on
Aviation Career Enrichment, Inc., or be contrary to its legitimate business interests; and any illegal activities
including piracy, cracking, extortion, blackmail, copyright infringement and unauthorized access to any
computers on the Internet or e-mailare forbidden.
4. Copyrighted materials belonging to entities other than Aviation Career Enrichment, Inc., may not be
transmitted by students on the companys network without permission of the copyright holder. Students must
respect all copyrights and may not copy, retrieve, modify or forward copyrighted materials, except with
2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 5 of 7)
Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

permission or as a single copy for reference only. Saving copyright-protected information to a network drive
without permission is prohibited. Sharing the URL (uniform resource locator or address) of an Internet site
with other interested persons for business reasons is permitted.

User Guidelines Continued

5. Students may not use the system in a way that disrupts its use by others. This includes sending or receiving
excessive numbers of large files and spamming (sending e-mail to thousands of users.)
6. To prevent contamination of Aviation Career Enrichment, Inc., technology and communications equipment
and systems by harmful computer viruses, downloaded files should be checked for possible infection through
the IT department. Also, given that many browser add-on packages (called plug-ins) may not be compatible
with other programs and may cause problems for the systems, downloading plug-ins is prohibited without
prior permission from IT.
7. Every student of Aviation Career Enrichment, Inc., is responsible for the content of all text, audio or image
files that he or she places or sends over the companys Internet and e-mail systems. No e-mail or other
electronic communications may be sent that hide the identity of the sender or represent the sender as
someone else. Aviation Career Enrichment, Inc. (ACE)s corporate identity is attached to all outgoing e-mail
communications, which should reflect corporate values and appropriate workplace language and conduct.
8. E-mail and other electronic communications transmitted by Aviation Career Enrichment equipment, systems
and networks are not private or confidential, and they are the property of the company. Therefore, Aviation
Career Enrichment reserves the right to examine, monitor and regulate e-mail and other electronic
communications, directories, files and all other content, including Internet use, transmitted by or stored in its
technology systems, whether onsite or offsite.
9. Internal and external e-mail, voice mail, and text messages are considered business records and may be
subject to discovery in the event of litigation. Students must be aware of this possibility when communicating
electronically within and outside the company.

STUDENT APPLICANT SIGNATURE PRINTED FIRST AND LAST NAME DATE

PARENT/LEGAL GUARDIAN SIGNATURE PRINTED FIRST AND LAST NAME DATE

BY SIGNING BELOW STUDENT APPLICANT AND PARENT/LEGAL GUARDIAN ACKNOWLEDGE,

UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS.

2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 6 of 7)

Revised June 4, 2017/PH
 FULTON COUNTY AIRPORT, BROWN FIELD 2017 2018
3940 AVIATION CIRCLE, NW
ATLANTA, GA 30336
Student Application
www.flyace.org

Aviation Career Enrichment, Inc. (ACE)s Right to Monitor and Consequences

for Misuse

All company-supplied technology, including computer systems, equipment and company-related work records,
belongs to Aviation Career Enrichment, Inc., and not to the student user. Students understand the company routinely
monitors use patterns, and students should observe appropriate workplace discretion in their use and maintenance of
such company property.

Because all the computer systems and software, as well as e-mail and Internet connections, are the property of
Aviation Career Enrichment, all company policies apply to their use and are in effect at all times. Any student who
abuses the company-provided access to e-mail, the Internet, or other electronic communications or networks,
including social media, may be denied future access, and, if appropriate, be subject to disciplinary action up to and

STUDENT APPLICANT SIGNATURE PRINTED FIRST AND LAST NAME DATE

PARENT/LEGAL GUARDIAN SIGNATURE PRINTED FIRST AND LAST NAME DATE

including termination, within the limitations of any applicable federal, state or local laws.

BY SIGNING BELOW STUDENT APPLICANT AND PARENT/LEGAL GUARDIAN ACKNOWLEDGE,

UNDERSTAND AND AGREE TO THE ABOVE STATEMENTS.

2017 2018 Aviation Career Enrichment, Inc. Student Application (Page 7 of 7)

Revised June 4, 2017/PH