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PAN AM i-20 APPLICATION

5000 NW 36TH STREET

MIAMI, FL 33122
Telephone (305) 874-6000
Fax: (305) 874-6612

Email Application to:

cvl@panamacademy.com
and
JVillamizar@panamacademy.com

Name of Applicant (Please print): Must be written as it appears on your passport

Last:___________________________First:_________________________Middle:_____________________
Present Address:
Street & Number___________________________________________City___________________________
State / Province __________________________ Country: ________________ Postal code______________
Telephone (include country code)__________________________EMAIL:__________________________
Emergency Contact (Please print):
Last:______________________________First:_______________________Middle:_____________________
Emergency Contact Address:
Street & Number_____________________________________City___________________________________
State / Province_________________________ Country: ________________Postal code _________________
Emergency Telephone (include country code)____________________________________________________
EMAIL ADDRESS:_________________________________________________________________________
Personal Information:
Gender: ___ Male ___Female Height: _____ Cm / Inch Weight:______ (Kilos /Lbs) Eyes:______________
Hair: _________ Place of Birth___________________________

Date of Birth:______/ _____/ ________

MONTH

Marital Status: ____ Single ____Married

DAY

YEAR

Current Occupation: _________________________________

Passport Number:_______________________

Country of Citizenship:_________________________

Drivers License (If applicable) _____________________________ Country: ________________________

Drug / Alcohol Conviction within the past 12 months: ________Yes _________No

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SCHOOL RECORDS
List the three most recent schools attended (High School, University, and Technical)
SCHOOL

LOCATION

DATES ATTENDED

DIPLOMA / DEGREE

FROM -------- / --------TO-------- / ---------FROM -------- / --------TO-------- / ---------FROM -------- / --------TO-------- / ----------

Student Housing Required? ____Yes _____No

Do you Smoke?

____Yes _____ No

FLIGHT EXPERIENCE (If Applicable):

List all Flight Certificates held:______________________________________________________________
Name of School where ratings were obtained: ___________________________________________
FAA Medical: _____None ____1st Class ____ 2nd Class ____ 3rd Class Date of Issue: ___________
PILOT TIME
TOTAL

CROSS
COUNTRY

INSTRUMENT

NIGHT

COMPLEX

SIMULATOR

SOLO
DUAL

FLIGHT COURSE REQUIRED

_____ PROFESSIONAL PILOT PROGRAM

(AB INITIO)
No previous experience required.
This course combines the private,
commercial, instrument and multiengine
courses marked with an asterisk ( * )

_____ TYPE RATING (PIC Initial)

EQUIPMENT
_________
Specify (B737, B777, A320, etc)

_____

_____ * PRIVATE

_____ CFI

_____ CFI II

_____ * COMMERCIAL

_____ CFI ME

_____ ATP

_____ * INSTRUMENT

_____ JET TRANSITION

_____ * MULTI-ENGINE

_____ FLIGHT ATTENDANT TRAINING

_____ AB INITIO (200 HOURS)

AIRCRAFT DISPATCHER TRAINING

_____ ADVANCED (80 HOURS)

_____ AB INITIO
_____ AIR TRAFFIC CONTROLLER

COURSE FEE:_________________

______ RECURRENT

DEPOSIT: ________________

DATE PAID:____________________

Sales/Account Executive: btodd@panamacademy.com Planned Start Date: _______________________

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APPLICATION AGREEMENT
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7.

8.

Please fill out this form entirely.

Attach a clear photocopy of a valid Passport, (if applicable attach license and visa)
Attach color passport picture ( 2X2)
Attach a bank statement demonstrating that you or your sponsors have the financial
resources required for your education in the US. (funds shown should reflect flight course
tuition)
Upon receipt of the above via e-mail, an I-20 form and acceptance letter will be sent to
you (applicant). You will then be able to proceed to a US Consulate or Embassy in your
country to request an M-1 visa.
Upon arrival to Pan Am International Flight Academy, students are enrolled according to
the requirements of the training center, the course purchased and US Government
regulations.
Before arrival, a deposit equal to 50% of the estimated tuition cost is required prior to
starting the Program. The remaining balance of 50% must be paid at arrival to Pan Am
International Flight Academy. (A minimum $2,500 deposit must be made prior to
Scheduling a class)
Student accepts that they have clearly read their sales agreement and fully understand
all elements of the training they are purchasing.

Signature Approval of Applicant:

I apply for admission to the course(s) indicated, and accept the above terms and conditions.
Student Signature:___________________________ Date: ______ / ______ / ______
MON
DAY
YEAR
Parent / Guardian Sponsors
Where the students are under the authority of parents, guardians, etc., the responsible authority
must sign here: I accept the above terms and conditions:
Parent / Guardian Signature:___________________________
Date: ______ / ______ / ______
MONTH
DAY YEAR
Relationship to student:_________________________________________
Parent / guardian Telephone (Include country code): __________________
Parent / guardian Address:
Street & Number___________________________________ City:__________________
State / Province: __________________ Postal Code / Zip___________ Country: ___________