1. Proposed Programme Details
Please Select Your Course * --- Recreational Pilot Licence Private Pilot Licence AVI50215 Diploma of Aviation (Commercial Pilot Licence - Aeroplane) AVI50415 - Diploma of Aviation (Instrument Rating) AVI50516 - Diploma of Aviation (Flight Instructor) Other Training (Please make note in Message section below)
Preferred Enrolment Type? * --- I would like to enrol full time using VET Student Loans if possible I would like to enrol full time using my own funding I would like to enrol part time using my own funding
2. Personal Information
Birth Date *
Gender * --- Male Female Other
Country of Birth * --- Australia New Zealand ------------- Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Bosnia & Herzegovina Botswana Brazil British Indian Ocean Territory Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Channel Islands Chile China Christmas Island Cocos Island Colombia Comoros Congo Cook Islands Costa Rica Cote D Ivoire Croatia Cuba Curaco Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territory Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guyana Haiti Hawaii Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea North Korea South Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malaysia Malawi Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Midway Islands Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Nambia Nauru Nepal Netherland Antilles Netherlands Nevis New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Island Palestine Panama Papua New Guinea Paraguay Peru Phillipines Pitcairn Island Poland Portugal Puerto Rico Qatar Republic of Montenegro Republic of Serbia Reunion Romania Russia Rwanda St Barthelemy St Eustatius St Helena St Kitts-Nevis St Lucia St Maarten St Pierre & Miquelon St Vincent & Grenadines Saipan Samoa Samoa American San Marino Sao Tome & Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Tahiti Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Is Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States of America Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (Brit) Virgin Islands (USA) Wake Island Wallis & Futana Is Yemen Zaire Zambia Zimbabwe
ID Type Attached * --- Passport Driver Licence 18+ Card Student ID Card Other
Nationality * --- Australian New Zealander ------------- Afghan Albanian Algerian American Andorran Angolan Antiguans Argentinean Armenian Austrian Azerbaijani Bahamian Bahraini Bangladeshi Barbadian Barbudans Batswana Belarusian Belgian Belizean Beninese Bhutanese Bolivian Bosnian Brazilian British Bruneian Bulgarian Burkinabe Burmese Burundian Cambodian Cameroonian Canadian Cape Verdean Central African Chadian Chilean Chinese Colombian Comoran Congolese Costa Rican Croatian Cuban Cypriot Czech Danish Djibouti Dominican Dutch East Timorese Ecuadorean Egyptian Emirian Equatorial Guinean Eritrean Estonian Ethiopian Fijian Filipino Finnish French Gabonese Gambian Georgian German Ghanaian Greek Grenadian Guatemalan Guinea-Bissauan Guinean Guyanese Haitian Herzegovinian Honduran Hungarian I-Kiribati Icelander Indian Indonesian Iranian Iraqi Irish Israeli Italian Ivorian Jamaican Japanese Jordanian Kazakhstani Kenyan Kittian and Nevisian Kuwaiti Kyrgyz Laotian Latvian Lebanese Liberian Libyan Liechtensteiner Lithuanian Luxembourger Macedonian Malagasy Malawian Malaysian Maldivan Malian Maltese Marshallese Mauritanian Mauritian Mexican Micronesian Moldovan Monacan Mongolian Moroccan Mosotho Motswana Mozambican Namibian Nauruan Nepalese New Zealander Nicaraguan Nigerian Nigerien North Korean Northern Irish Norwegian Omani Pakistani Palauan Panamanian Papua New Guinean Paraguayan Peruvian Polish Portuguese Qatari Romanian Russian Rwandan Saint Lucian Salvadoran Samoan San Marinese Sao Tomean Saudi Scottish Senegalese Serbian Seychellois Sierra Leonean Singaporean Slovakian Slovenian Solomon Islander Somali South African South Korean Spanish Sri Lankan Sudanese Surinamer Swazi Swedish Swiss Syrian Taiwanese Tajik Tanzanian Thai Togolese Tongan Trinidadian or Tobagonian Tunisian Turkish Tuvaluan Ugandan Ukrainian Uruguayan Uzbekistani Venezuelan Vietnamese Welsh Yemenite Zambian Zimbabwean
3. Emergency Contact Details
Relationship to you * --- Parent Partner / Spouse Brother or sister Cousin or other family member Friend or acquaintance
4. Background Information
Home Language/s * --- I only speak English I speak a second language at home (please specify)
Home Language (if relevant)
Cultural Heritage * --- I am not of either Aboriginal nor Torres Strait Islander origin I am of Aboriginal origin I am of Torres Strait Islander origin I am of both Aboriginal and Torres Strait Islander origin
Please note that regardless of background, all pilots are required by the Civil Aviation Safety Authority (CASA) to undertake an Aviation English Test. If you have concerns about this, please
contact us for further assistance.
Do you consider yourself to have a disability, impairment or long term condition? * --- NO, I do not consider myself to have a disability, impairment or long term condition YES, I do consider myself to have a disability, impairment or long term condition
5. Education & Employment Details
Air Gold Coast is a registered Training Organisation approved for the VET Student Loans system for domestic students. Please confirm below your intention to apply for VET student Loans to support payment of your training tuition fees. Please note that the VET Student Loans system may only be accessed by eligible students and Air Gold Coast in no way proposes or warrants that you may be eligible. Additionally, the number of VET Student Loans places in the course is limited with availability on a first come, first served basis.
File Size: 4MB limit. File Types: pdf (preferred), jpg, doc, docx.
By submitting this form, I acknowledge the following: