Private Pilot Ground School

Private Pilot Ground School

First Name:
Middle Name:
Last Name:
Preferred Name:
e-mail:	sample-applicant@example.com
Birthdate:
Cell Phone:
Are you a US Citizen?	Yes    No
Are you a male or female student?	Male   Female
What is your high school grade level?	10th 11th 12th
Are you a Virginia Resident?	Yes    No

Name:
Relationship to Student:
Address:
	, AK AL AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PA PW PR RI SC SD TN TX UT VT VI VA WA WV WI WY
Cell Phone:
Email:

	The dates for the online course session will be between August 1 and September 21, 2023. Live sessions will take place Tuesday and Thursday evenings from 6pm-8pm. Selected participants will be required to commit themselves to this entire time period of that session in order to participate in the Private Pilot Ground School I confirm that I have no other time commitments between August 1 and September 21, 2023 that would preclude my involvement in this program. Yes   No
Will you be 16 prior to the start of this program?	Yes   No
Have you ever participated in past VSGC Programs?	Yes   No Please list all VSGC programs and year of participation:
Please list any prior aviation experience here:

School Name:
School Address:
	, AK AL AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PA PW PR RI SC SD TN TX UT VT VI VA WA WV WI WY
GPA:	Note: 3.0 GPA Required: Please attach an unofficial high school transcript with your application. Your official transcript will be requested upon selection.
Transcript:	File Upload (PDF format)
List all extra-curricular activities, organizations, and honors:

As part of your application you are required to provide a letter of recommendation from an individual who is not a relative. Your reference must be from a teacher, school administrator, counselor, or flight instructor who can attest to your academic qualifications or your flight instruction history. When you submit your application, the application system will forward the letter of recommendation form to your selected references. Your reference will submit the completed form directly to this system via an online form. You are responsible for ensuring that your reference request has been received by your chosen reference provider, completed in a timely manner, and submitted before the deadline of Wednesday, July 26, 2023.

Reference 1
Full Name:
Relationship to Student:
Institution:
Phone:
Email Address:
Confirm Email Address:

After your application is submitted, the individual you have designated will receive an email request from notices@spacegrant.net for this information on your behalf. Reference letters are due by Wednesday, July 26, 2023. Please complete an essay in your own words using the following questions:

1. Describe yourself to us: your academic strengths, interests, and personal characteristics.
2. What kind of extra-curricular activities or hobbies have you engaged in that are meaningful to you?
3. Tell us about any past aviation experiences and goals you have towards a career as pilot.
4. Explain why you wish to participate in the Private Pilot Ground School and how participating would impact your career goals as a pilot.

Note: This essay is a critical component in the selection process. It is your chance to present yourself to the selection panel. Answer all questions completely in your essay. Please use approximately 500-600 words.

How did you hear about this program?
Do you already have specific plans to pursue your private pilot's license?	Yes   No Please describe your plan
How many flight hours, if any, have you logged as a pilot?

Students are strongly encouraged to provide the information requested below. This information is collected for federal reporting purposes only and is not accessible to the program's selection panel.

Ethnicity:	Hispanic or Latino Not Hispanic or Latino
Race:	American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Other Pacific Islander White

I certify that I am a U. S. citizen and that my answers are true and complete to the best of my knowledge. I understand that I must work through the entirety of the 8 week online course session.

If this application leads to my selection, I understand that false or misleading information in my application or interview may result in my disqualification from participation.

Student Name: I fully support my child's participation in the Private Pilot Ground School. I will assist in providing access to the online course sessions for my child.

The course is being offered free of charge to selected participants. In addition, each student will receive the reference materials required for the course at a cost to VSGC of approximately $50. Note: If a student registers for and fails to complete the course, they must reimburse VSGC for this funding.

I understand that, if selected, my student will be required to participate throughout the 8 week session without interruption for the time period of their session.

An email will be sent to the student and legal guardian's email, confirming the student's application.

An email will be sent to the student and legal guardian's email, confirming the student's application.

Guardian's Name: