URLThis field is for validation purposes and should be left unchanged.Applicant InformationApplicant Entity Type:(Required) Individual Partnership Corporation LLC Joint Venture Other Applicant Name(Required)Applicant's Name(Required) First Last Applicant's Company Name(Required)(N/A if you don't have one)Owner's Name(Required) First Last Owner's DOB(Required) MM slash DD slash YYYY Owner's Position(Required)Applcant's DOB(Required) MM slash DD slash YYYY Aplicant's Position(Required)What is the corporate name of the applicant?(Required)This is the name that goes on tax returns.Business Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is this the same as the mailing address?(Required) Yes No Mailing Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Fax:Email:(Required) FEIN (Tax ID #):(Required)Contact Person:(Required)Does the applicant have a DBA (Doing Business As) name:(Required) Yes No If so, please list the DBA name:(Required)Do you operate at multiple locations?(Required) Yes No If yes, list all locations:(Required) Add RemoveIn what year did the applicant start operations?(Required)2026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Is this entity a franchise?(Required)Applicant pays for the right to operate under the franchisor's brand and system, the franchisor being the one that owns the brand, products, and business model Yes No Describe what type of service(s) the applicant provides (Please describe in detail):(Required)Website (if applicable): Years in business:(Required)Please enter a number greater than or equal to 0.Annual Revenue(Required)Please enter a number greater than or equal to 0.Total Full Time Employees:(Required)Please enter a number greater than or equal to 0.Total Part Time Employees:(Required)Please enter a number greater than or equal to 0.Total Contractors:(Required)Please enter a number greater than or equal to 0.What are your standard operating hours?(Required)FAA Part 61 or Part 141 Certified?(Required) Yes No Flight Training OperationsWhat type of pilot training programs does your school offer? (Select all that apply)(Required) Private Pilot License (PPL) Instrument Rating (IR) Commercial Pilot License (CPL) Multi-Engine Training Certified Flight Instructor (CFI) Training Airline Transport Pilot (APT) Recreational or Sport Pilot Training Drone/UAV Pilot Training Other If other, please explain:(Required)What is your approximate annual student enrollment?(Required)Does your school provide simulator training?(Required) Yes No If yes, what types of flight simulators are used?(Required)Do you offer discovery flights or introductory flights for the public?(Required) Yes No If yes, please describe:(Required)Pilot QualificationsPilot Information(Required)NameAgePilot No.FAA Certification No.Aircraft ModelDates Attended Add RemoveMemberships/Organizations: AOPA EAA ABS CPA BOA Other If other, please explain:(Required) Do any pilots named above have any: (a) Physical impairments?(Required) Yes No (b) Waivers, limitations, conditions attached to their medical certificates?(Required) Yes No Has any FAA or Pilot certificate ever been suspended or revoked?(Required) Yes No Has any pilot ever been involved in any aircraft accident?(Required) Yes No Has any applicant, officer, partner, or pilot ever been indicted or been arrested for a felony, drunk driving, or reckless operation of any vehicle?(Required) Yes No Has any applicant, officer, partner, or pilot ever been indicted or convicted in a legal action involving drugs?(Required) Yes No If yes to any above, please describe:(Required)Aircraft Usage & Fleet DetailsDoes your school own and/or lease the aircraft used for training?(Required) Own Lease Finance For each aircraft:(Required)MakeModelYearRegistration Number (Tail Number)Serial Number Add RemoveType of aircraft(s):(Required)(e.g., single-engine, multi-engine, piston, turboprop, jet helicopter)Current insured hull value for each aircraft (replacement cost or agreed value):(Required)If financed/leased, what is the lienholder/lessor name?(Required)Loan number:(Required)What is the lienholder/lessor address?(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code What is the lien amount?(Required)Is the aircraft hangared, tied down, or moored at its base airport?(Required)Total airframe hours and engine hours (for each engine):(Required)Hours flown in the last 12 months for each aircraft?(Required)AircraftHours Flown Add RemoveDate of last annual inspection and any other significant maintenance events:(Required)Has the aircraft been equipped with any modifications not provided by the original manufacturer that alter its flying characteristics?(Required)Is there any unrepaired damage to the aircraft?(Required)Will the aircraft be operated outside the contiguous United States?(Required) Yes No If so, where and for what duration?(Required)What is the intended use of each aircraft?(Required)(e.g., primary trainer, instrument trainer, multi-engine trainer, checkride aircraft)Aircraft TypeUsage Type Add RemoveHow often are aircraft maintenance and inspections performed?(Required)Do you maintain detailed maintenance logs in compliance with FAA regulations?(Required) Yes No Do you rent aircraft to non-students?(Required) Yes No Do you allow solo flights for student pilots?(Required) Yes No If yes, describe safety protocols:(Required)Flight Instructors & Student SafetyHow many flight instructors are currently employed by your school?Full-time(Required)Please enter a number greater than or equal to 0.Part-time(Required)Please enter a number greater than or equal to 0.Contracted(Required)Please enter a number greater than or equal to 0.Are all instructors FAA-certified and current on required training?(Required) Yes No Does your school require instructors to undergo periodic proficiency training?(Required) Yes No Do you have a minimum flight hour requirement for hiring instructors?(Required) Yes No If yes, what is the minimum requirement?(Required)Are students required to sign liability waivers before training?(Required) Yes No What is the minimum age requirement for students?(Required)Please enter a number from 1 to 99.Do you have a documented emergency response plan for flight-related incidents?(Required) Yes No Do students undergo Pre-Flight Safety Training?(Required) Yes No Are students required to have Renter's Insurance?(Required) Yes No Do you conduct background checks on students?(Required) Yes No What is the typical student-to-instructor ratio?(Required)Facilities & Safety MeasuresDoes your school own, lease, or sublease its facilities?(Required) Own Lease Sublease Where does flight training take place?(Required) Public Airport Private Airfield Other What is the total square footage of your hangars and office space?(Required)Does your facility include an on-site aircraft maintenance area?(Required) Yes No Are fire suppression systems installed in hangars and fuel storage areas?(Required) Yes No What security measures are in place at your facility?(Required)(Select all that apply) Surveillance cameras Keycard access or restricted entry Fencing and perimeter security On-site security personnel Do you perform regular maintenance on aircraft?(Required) Yes No If yes, how often?(Required)Who performs maintenance on aircraft?(Required)(Select all that apply) In-House Mechanics Third-Party Maintenance Providers Aircraft Manufacturer Service Center Do you have any history of FAA Violations or Citations?(Required) Yes No If yes, provide details:(Required)Employees & Workers' CompensationTotal number of non-instructor employees:Full-time(Required)Please enter a number greater than or equal to 0.Part-time(Required)Please enter a number greater than or equal to 0.Are all employees required to complete safety training?(Required) Yes No Does your school conduct background checks and drug screenings for employees?(Required) Yes No Do you currently have workers' compensation coverage in place?(Required) Yes No If so, what carrier?(Required)Insurance History & Claims InformationCurrent Insurance Carrier (if applicable):Current Policy Expiration Date: MM slash DD slash YYYY Requested coverage limits: General Liability:(Required)per occurrencePlease enter a number greater than or equal to 0.General Liability:(Required)aggregatePlease enter a number greater than or equal to 0.Aircraft Hull Coverage:(Required)Please enter a number greater than or equal to 0.Non-Owned Aircraft Liability:(Required)Please enter a number greater than or equal to 0.Student & Instructor Liability:(Required)Please enter a number greater than or equal to 0.Hangar Keepers Liability:(Required)Please enter a number greater than or equal to 0.Medical:(Required)Please enter a number greater than or equal to 0.Other (Specify):Please enter a number greater than or equal to 0.Do you have prior insurance claims in the last five years?(Required) Yes No If yes, provide details including date, amount paid, and type of claim:(Required)Has any insurer canceled or declined coverage in the last five years?(Required) Yes No If yes, please provide details:(Required)Coverage Interests & Additional ProtectionPlease select the types of coverage you are interested in:(Required) Aircraft Hull & Liability Insurance Hangarkeepers Liability (for aircraft stored at your facility) Flight Instructor Professional Liability Cyber Liability (for data breaches or online student transactions) Pollution Liability (for fuel spills and hazardous materials) Workers' Compensation Student Pilot Liability Coverage Business Interruption Insurance Commercial General Liability Other Other (please specify):(Required)Are individual instructor liability policies required or is coverage provided under the flight school's policy?(Required)Does the flight school perform maintenance on aircraft not owned by the school? If so, what is the maximum value of non-owned aircraft typically kept in the hangar?(Required)Does the flight school sell any aircraft parts, accessories, or provide any maintenance services to third parties? If so, describe:(Required)Premises LiabilityDescribe the flight school's facilities, including classrooms, offices, hangars, and common areas:(Required)Are there any unique exposures on the premises (e.g., fuel operations, public access areas)?(Required)Additional Comments or Special ConsiderationsPlease provide any other relevant information that may impact your insurance coverage needs: Δ
