PILOT REGISTRATION FORM

Complete the information below and submit. You'll receive an e-mail within 14 days confirming your registration in the EAA Ultralight Pilot Program.
This program is an EAA member benefit and free of charge to EAA members.
  

*Pilot  Name:
*Pilot  EAA #:
*Pilot  Address:

*Pilot  City:
Pilot  State:
Pilot  Zip/Postal Code:  
Pilot  Phone:
*Pilot  E-mail:
Pilot Qualified: Fixed-wing  Powered Parachute
Weight-shift Powered Paraglider
 
*Instructor Name: 
*Instructor Address: 
 
 
*Instructor City: 
Instructor State: 
Instructor Zip/Postal Code: 
Instructor Phone: 
Instructor E-mail: 
Instructor Type:  FAA CFI 
*Instructor #: 

  
By submitting the preceding information, your are certifying that you have completed the requirement of the EAA pilot registration program as described in the EAA training guide for ultralights.

    

For questions or more information, contact:
EAA Ultralight Programs

P.O. Box 3086
Oshkosh, WI 54903-3086
Telephone: 920-426-6527
E-mail: ultralights@eaa.org