Minnesota Aviation Hall of Fame
P.O. Box 53, Park Rapids, MN 56470
AVIATION CANDIDATE BACKGROUND QUESTIONNAIRE
Name of Candidate (last, first, middle initial) *
Your answer
Place of birth
Your answer
Birthdate
Your answer
Came to Minnesota in what year
Your answer
Date of death
Your answer
Place interred
Your answer
Cause of death
Your answer
First airplane ride -where
Your answer
Date
Your answer
With whom as pilot
Your answer
Type of aircraft
Your answer
First solo -where
Your answer
Date
Your answer
Type of aircraft
Your answer
Your instructor
Your answer
What year did you receive your Private license
Your answer
Additional licenses
Your answer
Place where you took your lessons
Your answer
Private license signed by
Your answer
Did you do any barnstorming and where
Your answer
Did you own your own aircraft
Your answer
Types
Your answer
What other types of aircraft have you flown through the years
Your answer
Did you fly in the military
Your answer
Where
Your answer
What unit (s)
Your answer
Awarded medals
Your answer
Did you fly for an airline
Your answer
Which ones
Your answer
Years
Your answer
Aircraft flown
Your answer
Did you ever build your own aircraft
Your answer
From your own design
Your answer
Kit
Your answer
From your own design
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Year built
Your answer
Did you fly as a Corporate Pilot
Your answer
For whom
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Based where
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Aircraft flown
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Occupation other than aviation
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Other hobbies
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Next of Kin
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Street address
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City, State,ZIP
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Name of Submitter *
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Submitter Home Phone *
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Submitter E Mail Address *
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Signature
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Date
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This information may be used for historical purposes only.
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