LadiesLoveTaildraggers "Tailwheel Endorsement Scholarship" Application Form

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Scholarship includes 6 hours flight instruction in a 1948 Cessna 140; time and aircraft donated by Brian Lansburgh (Tailwheeler's Journal). Location: 6K5, Sisters Eagle Air Airport, Sisters, Oregon. All ground school is included. Tailwheel Endorsement includes a Biennial Flight Review. Value $850.00. Travel, lodging, car rental and meal expenses up to $1,000.00 donated by LadiesLoveTaildraggers. Total Scholarship value up to $1,850.00.

Requirements for applicants:
- Must be female
- Must be a minimum 21 years old
- Must hold a minimum of Sport Pilot license
- Must be a U.S. citizen
- Must weigh no more than 180 pounds
- Must sign a Tailwheel Productions & LadiesLoveTaildraggers Model Release Form (photos & video may be taken during training)
- Must be passionate about earning a tailwheel endorsement!

I. Personal Information

First Name *

Middle Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip Code *

Home Phone Number

Cell Phone Number

Email *

Repeat Email *

Present Employement *

Employer, position and years held

Age *

II. Flight Experience

How many years have you held a pilot's license *

Certificates and ratings held *

Number of Hours Logged *

Number of hours flown in the last 12 months *

Make and model of aircraft you have flown and approx. hours logged in each *

The aircraft I typically fly *

I own

I am a partner

I am in a flying club

I rent/lease

I am not current

III. Personal Statements

Tell us about yourself.

1) You are a pilot. What made you want to learn to fly? *

2) Why is getting a tailwheel endorsement important to you? *

3) How will flying a taildragger aircraft impact your future? *

4) Is there anything that sets you apart from other scholarship applicants? *

5) Describe one of your mentors and why you respect her/him. *

IV. References

List two references (not related to you) who are involved in aviation.

Reference #1: Name *

Phone Number *

Email *

How do you know this person? *

Reference #2: Name *

Phone *

Email *

How do you know this person? *

Do you have additional comments you would like to share?

Submission

Applications must be received no later than June 15, 2014, unless otherwise stated. Winner will be announced on www.LadiesLoveTaildraggers.com. Only scholarship winner will be personally notified. Additional information or verification may be requested.

By submitting this form I hereby certify that the information I have submitted is true and correct to the best of my knowledge.

For problems or questions with this form, please email LadyTaildraggers@gmail.com

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