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Personal Information

Full Name

Date Of Birth

Gender:

Male Female Other

Nationality:

Passport Number (if applicable):

Phone Number

Email Address:

Professional Information:

Current Job Title:

Company Name:

Industry/Department:

Years of Experience in Aviation:

Relevant Qualifications/Certifications:

Course Title:

Course Date (if known):

Preferred Training Format:

In-Person Virtual Hybrid (Both In-Person & Virtual)

Reason for Enrolling:

Emergency Contact Information:

Name:

Relationship to Applicant:

Phone Number:

Email Address:

Payment Information (For Fee-Paid Courses):

Payment Method:

Amount: (Specify UGX or USD)

Transaction Reference Number (if applicable):

Declaration and Signature:

Declaration

I hereby confirm that the information provided above is accurate and true to the best of my knowledge. I understand that this application is for the training program offered by AviaPal Consultancy Ltd. and that any falsification of details may result in disqualification.

Applicant’s Initials

Date: